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Record W4239380220 · doi:10.1108/cgij-07-2014-0023

Targeting Lyme

2014· article· en· W4239380220 on OpenAlex
David Birnbaum

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueClinical Governance An International Journal · 2014
Typearticle
Languageen
FieldImmunology and Microbiology
TopicVector-borne infectious diseases
Canadian institutionsnot available
Fundersnot available
KeywordsGuidelineDenialTransparency (behavior)Psychological interventionPublic relationsPolitical sciencePsychologyMedicineEngineering ethicsNursingPsychotherapistLawEngineering

Abstract

fetched live from OpenAlex

Purpose – The purpose of this paper is to describe recent passage of a private member's bill that can put Canada on a different path from the USA in attempting to resolve conflict that arose over how an influential clinical practice guideline for Lyme disease was developed. Design/methodology/approach – Narrative review. Findings – Critical appraisal of pertinent scientific literature is fundamental to the production of evidence-based practice guidelines. Perception of fairness and transparency in a guideline development process is fundamental to wide acceptance. Allegations of conflicts of interest and excluding opposing views in development of Lyme disease guidelines led to legislative interventions after insurers started basing denial of claims and licensing boards started responding to complaints against physicians whose treatment regimens were inconsistent with guideline statements on chronic Lyme disease. Opposing sides are both faced with limitations in available research evidence. Claims and counterclaims about availability of impartial subject matter experts free of vested interests arose; however, this has been compounded by failures in communication channels. Perhaps most importantly, and the focus of this viewpoint, wide perception among those afflicted of a flawed guideline development process makes it unlikely that all sides can reach agreement on this path. Canada, unlike the USA, is taking steps to include all stakeholders (including representatives of the medical community and of patients’ groups) in a review meeting to develop a comprehensive national framework. Research limitations/implications – This situation provides a noteworthy example of defining best practice in the difficult situations where stakes are high, diagnostic tools are flawed, some of those identified as experts have vested interests, and patients with unmet needs feel excluded. Originality/value – The next steps in Canada bear watching, both in terms of potentially resolving key conflicts around the one guideline document in question, and also as a potential model for a more successful guideline development process.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesInsufficient payload (model declined to judge)
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.383
Threshold uncertainty score0.999

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0020.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.022
GPT teacher head0.339
Teacher spread0.317 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it