Bibliographic record
Abstract
The author responds; The issues raised by Dr Marcos Almeida are indeed relevant to our study, and to clubfoot management in general. He is of the opinion that compliance varies with time, with which we are in agreement. However, in the absence of data, it is difficult to say at what time during bracing the compliance is the highest or lowest. Likewise, confounding factors, such as education level of the guardian/parent, financial status, additional support systems for the Ponseti treatment (counselling team), distance from home to health facility, etc, are likely to affect compliance. We attempted to capture as much data about these variables as was possible in our program. For instance, we incorporated a counselling arm to run parallel with the medical arm for clubfoot management. Specifically, before starting the treatment, potential clients undergo a counselling session in which they receive guidance on what to expect throughout the treatment phases. They are shown the brace ahead of time, and even see it worn by children already undergoing treatment. This prepares the clients psychologically; thus, they are not taken by surprise when the time comes for bracing. Furthermore, the counsellor keeps track of the patients, and follows up with those who miss an appointment. With this in mind, and from our general observation, we do not believe that there was a significant difference, if any, in compliance at six months compared with a period earlier than six months. On the contrary, we have the impression that compliance tended to decline with time due to fatigue, or a feeling that the correction had already been achieved and, therefore, no further need for bracing was seen. With regard to the psychosocial effect on compliance, our questionnaire addressed issues such as how difficult it was for parents to accept the brace, whether there was stigma from society regarding the use of the brace, etc. In summary, we believe that the practicability of the brace, together with incorporation of a counselling arm in the treatment of clubfoot, had a direct positive influence toward the high compliance rate that we observed. As Dr Almeida points out, these additional factors are crucial to be taken into account during prospective studies comparing compliance rates at different stages of bracing. We appreciate Dr Almeida elevating this important insight to its proper visibility.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.036 | 0.022 |
| Insufficient payload (model declined to judge) | 0.014 | 0.007 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".