Bibliographic record
Abstract
We thank Dr. Diercks for his valuable comments regarding our article.1Marquardt B. Witt K.A. Liem D. Steinbeck J. Potzl W. Arthroscopic Bankart repair in traumatic anterior shoulder instability using a suture anchor technique.Arthroscopy. 2006; 22: 931-936Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar He may certainly be correct in his concerns about the use of the Constant score as a measurement tool for patients with shoulder instability in our study. The Western Ontario Shoulder Instability Index indeed appears to be a sensitive measurement tool in these patients, because it focuses on the patient’s own perception of changes in health status.2Kirkley A. Griffin S. McLintock H. Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability—The Western Ontario Shoulder Instability Index (WOSI).Am J Sports Med. 1998; 26: 764-772Crossref PubMed Scopus (330) Google Scholar However, its use in the current literature is not very widespread. The Constant score assesses pain, function, range of motion, and strength and thus combines subjective and objective parameters. It is of common use in clinical studies dealing with shoulder instability and therefore allows good comparison of our own results.3Fabbriciani C. Milano G. Demontis A. Fadda S. Ziranu F. Mulas P.D. Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study.Arthroscopy. 2004; 20: 456-462Abstract Full Text Full Text PDF PubMed Scopus (242) Google Scholar, 4Gartsman G.M. Roddey T.S. Hammerman S.M. Arthroscopic treatment of anterior-inferior glenohumeral instability Two to five-year follow-up.J Bone Joint Surg Am. 2000; 82: 991-1003PubMed Google Scholar, 5Rhee Y.G. Ha J.H. Cho N.S. Anterior shoulder stabilization in collision athletes: Arthroscopic versus open Bankart repair.Am J Sports Med. 2006; 34: 979-985Crossref PubMed Scopus (151) Google Scholar That was the main rationale for our use of this score in our evaluation.A preoperative Constant score of about 60 points seems to be widely reported in the current literature.3Fabbriciani C. Milano G. Demontis A. Fadda S. Ziranu F. Mulas P.D. Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study.Arthroscopy. 2004; 20: 456-462Abstract Full Text Full Text PDF PubMed Scopus (242) Google Scholar, 4Gartsman G.M. Roddey T.S. Hammerman S.M. Arthroscopic treatment of anterior-inferior glenohumeral instability Two to five-year follow-up.J Bone Joint Surg Am. 2000; 82: 991-1003PubMed Google Scholar In our experience, recurrent traumatic anterior shoulder instability usually results in a severe loss of strength, loss of motion as a result of apprehension, and thus, restriction in sports and activities of daily living, which finally results in a Constant score between 55 and 65 points. This is even true for a young patient population of collision athletes.5Rhee Y.G. Ha J.H. Cho N.S. Anterior shoulder stabilization in collision athletes: Arthroscopic versus open Bankart repair.Am J Sports Med. 2006; 34: 979-985Crossref PubMed Scopus (151) Google Scholar We thank Dr. Diercks for his valuable comments regarding our article.1Marquardt B. Witt K.A. Liem D. Steinbeck J. Potzl W. Arthroscopic Bankart repair in traumatic anterior shoulder instability using a suture anchor technique.Arthroscopy. 2006; 22: 931-936Abstract Full Text Full Text PDF PubMed Scopus (48) Google Scholar He may certainly be correct in his concerns about the use of the Constant score as a measurement tool for patients with shoulder instability in our study. The Western Ontario Shoulder Instability Index indeed appears to be a sensitive measurement tool in these patients, because it focuses on the patient’s own perception of changes in health status.2Kirkley A. Griffin S. McLintock H. Ng L. The development and evaluation of a disease-specific quality of life measurement tool for shoulder instability—The Western Ontario Shoulder Instability Index (WOSI).Am J Sports Med. 1998; 26: 764-772Crossref PubMed Scopus (330) Google Scholar However, its use in the current literature is not very widespread. The Constant score assesses pain, function, range of motion, and strength and thus combines subjective and objective parameters. It is of common use in clinical studies dealing with shoulder instability and therefore allows good comparison of our own results.3Fabbriciani C. Milano G. Demontis A. Fadda S. Ziranu F. Mulas P.D. Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study.Arthroscopy. 2004; 20: 456-462Abstract Full Text Full Text PDF PubMed Scopus (242) Google Scholar, 4Gartsman G.M. Roddey T.S. Hammerman S.M. Arthroscopic treatment of anterior-inferior glenohumeral instability Two to five-year follow-up.J Bone Joint Surg Am. 2000; 82: 991-1003PubMed Google Scholar, 5Rhee Y.G. Ha J.H. Cho N.S. Anterior shoulder stabilization in collision athletes: Arthroscopic versus open Bankart repair.Am J Sports Med. 2006; 34: 979-985Crossref PubMed Scopus (151) Google Scholar That was the main rationale for our use of this score in our evaluation. A preoperative Constant score of about 60 points seems to be widely reported in the current literature.3Fabbriciani C. Milano G. Demontis A. Fadda S. Ziranu F. Mulas P.D. Arthroscopic versus open treatment of Bankart lesion of the shoulder: A prospective randomized study.Arthroscopy. 2004; 20: 456-462Abstract Full Text Full Text PDF PubMed Scopus (242) Google Scholar, 4Gartsman G.M. Roddey T.S. Hammerman S.M. Arthroscopic treatment of anterior-inferior glenohumeral instability Two to five-year follow-up.J Bone Joint Surg Am. 2000; 82: 991-1003PubMed Google Scholar In our experience, recurrent traumatic anterior shoulder instability usually results in a severe loss of strength, loss of motion as a result of apprehension, and thus, restriction in sports and activities of daily living, which finally results in a Constant score between 55 and 65 points. This is even true for a young patient population of collision athletes.5Rhee Y.G. Ha J.H. Cho N.S. Anterior shoulder stabilization in collision athletes: Arthroscopic versus open Bankart repair.Am J Sports Med. 2006; 34: 979-985Crossref PubMed Scopus (151) Google Scholar About “Arthroscopic Bankart Repair …”ArthroscopyVol. 23Issue 6PreviewAfter reading the recently published article by Marquardt et al.,1 I have some questions concerning the inclusion and the outcome measures that were used. The Constant score is used as an outcome measure by the authors. Kirkley et al.2,3 stated that this instrument may be useful for discriminating between patients with significant rotator cuff disease or osteoarthritis but it is not useful for patients with instability. In fact, in one study all of the patients with instability of the shoulder scored nearly perfectly (95 to 100) despite having problems of sufficient magnitude to request surgical intervention. Full-Text PDF
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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 | 0.006 | 0.107 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.025 | 0.031 |
| Insufficient payload (model declined to judge) | 0.042 | 0.019 |
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".