From Canadian Living Guidelines to Global Living Guidelines: A Post Pandemic Effort
Bibliographic record
Abstract
Since the coronavirus disease 2019 (COVID-19) pandemic, “living” practice guidelines are increasingly being used to ensure that recommendations are responsive to rapidly emerging evidence. In this issue of The Journal of Rheumatology , Hazlewood et al provide living recommendations on the issue of biologic (b-) and targeting synthetic (ts-) disease-modifying antirheumatic drug (DMARD) de-escalation in adults with rheumatoid arthritis (RA).1 The panel recommends that patients with RA in sustained remission or low disease activity for at least 6 months and ideally 12 months, upon glucocorticoid discontinuation, are offered a trial of stepwise tapering (ie, extension of interval between doses or dose reduction) but no discontinuation of bDMARD (ie, originator and biosimilars) and tsDMARD therapy. This is a conditional recommendation, meaning that “the majority of people with RA in this situation would want the suggested course of action, but many would not.”1 This recommendation is meant to be based on a shared decision including the discussion of a flare management plan and only in patients who have rapid access to rheumatology care in case of flare. If access to care is … Address correspondence to Dr. I. Colmegna, The Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Office # EM2-3238, Montreal, QC H4A 3J1, Canada. Email: ines.colmegna{at}mcgill.ca.
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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 | 0.074 | 0.221 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.008 |
| Science and technology studies | 0.010 | 0.010 |
| Scholarly communication | 0.017 | 0.011 |
| Open science | 0.010 | 0.012 |
| Research integrity | 0.024 | 0.028 |
| Insufficient payload (model declined to judge) | 0.030 | 0.010 |
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".