Bibliographic record
Abstract
The management of asthma in children is still based largely on the experience gained from treating the adult population. Because of the inflammatory nature of asthma and the high number of atopic individuals with asthma, the use of leukotriene receptor antagonists (LTRA) in the asthma management of children would intuitively make sense. However, clinically, and as noted in the above data analysis, the response of children to LTRAs is mixed. The last Canadian Asthma Consensus Guidelines of 1999 (1), suggested that LTRAs be used for mild intermittent and mild persistent asthma, and should be considered as add-on therapy to the use of inhaled corticosteroids (ICS) in moderate to severe asthmatics. In patients with moderate to severe asthma, LTRAs alone do not offer the same degree of asthma coverage as the use of ICS when considering the more significant features of asthma, that being lung function by spirometry, beta2-agonist usage, and asthma exacerbations (2). Since the development of long-acting bronchodilators (LABA) in combination with ICS, the exact role of LTRA as add-on therapy for moderate to severe asthma has further been questioned. It appears that the powerful bronchodilator properties of the LABAs improve lung function more than the addition of an LTRA (3). The Investigation of Montelukast as a Partner Agent for Complementary Therapy trial of a long-term comparison between LTRA and LABA as add-on therapy to ICS is still ongoing and the results will be interesting (4). Recently, the LTRA, montelukast (Singulair [Merck Frosst Canada Ltd, Canada]), has been given the clinical indication for the treatment of allergic rhinitis in the United States. There is evidence that improvement of nasal function does offer benefits to lower airway function (5). In addition, the use of montelukast in children with asthma has been suggested to improve nasal symptoms compared with placebo. Whether this improvement will also allow a decrease in ICS dose or improved clinical outcome of asthma patients already on ICS has yet to be demonstrated even in adults. Further studies in children are necessary to confirm this possible upper airway effect and its role in asthma. In general though, paediatric studies for many of the accepted drugs we use in asthma are limited, thus the focus still needs to be on performing the needed studies. At this time, the use of an LTRA in addition to ICS in the management of children with asthma is occurring, but the actual data supporting this practice unfortunately are still in question.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.629 | 0.510 |
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".