Treatment preferences in juvenile idiopathic arthritis – a comparative analysis in two health care systems
Bibliographic record
Abstract
Pediatric Rheumatologists in Canada (n=58) and Germany/Austria (n=172) were surveyed by email, using case-based vignettes for oligoarthritis and seronegative polyarthritis. Data was analyzed using descriptive statistics; responses were compared using univariate analysis. Total response rate was 63%. Physicians were comparable by age, level of training and duration of practice, but more Canadians were based in academic centers. German physicians were more likely to institute DMARD treatment in oligoarthritis refractory to NSAID (p<0.001), and oral steroid treatment in uveitis (p=0.043). Canadian physicians were more likely to switch to a different DMARD rather than a biologic agent in polyarthritis refractory to DMARD. Both physician groups agreed on time to judge effectiveness of DMARDs (mean 4.2 months) and time to switch to biologic treatment (mean 5.4 months). 86% and 90% of German physicians preferred regular physiotherapy over home exercise compared to 14% and 15% in Canada for oligoarthritis and polyarthritis, respectively. Except for a Canadian preference for Naproxen in oligoarthritis, no significant differences were found for NSAID, intraarticular steroid preparations, initial DMARD and initial biologic treatment. Treatment of oligo- and polyarticular JIA with DMARD follows established guidelines, while usage of intraarticular steroids and biologic agents is variable within and between physician groups. Physiotherapy has a fundamentally different role in the two health care systems.
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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 | 0.002 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".