Role of the Neutrophil to Lymphocyte Ratio in Guillain Barré Syndrome: A Systematic Review and Meta-Analysis
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Bibliographic record
Abstract
In this study, we conducted a systematic review and meta-analysis regarding the role of the neutrophil to lymphocyte ratio (NLR) in Guillain Barré syndrome (GBS). The most recent update to the search was on July 18, 2022, through the databases of Web of Science, PubMed, Embase, and Scopus. The Newcastle-Ottawa scale was used for quality assessment of included studies. Finally, 14 studies were included in the review, and among them, ten studies were included in the meta-analysis. Our results showed that NLR levels were significantly increased in the patients with GBS compared with healthy controls ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mtext>SMD</a:mtext> <a:mo>=</a:mo> <a:mn>1.05</a:mn> </a:math> ; <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>95</c:mn> <c:mi>%</c:mi> <c:mtext>CI</c:mtext> <c:mo>=</c:mo> <c:mn>0.59</c:mn> </c:math> to 1.50, <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo><</e:mo> <e:mn>0.001</e:mn> </e:math> ). After treatment, NLR levels were decreased to the extent that they became similar to healthy controls ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mtext>SMD</g:mtext> <g:mo>=</g:mo> <g:mo>−</g:mo> <g:mn>0.03</g:mn> </g:math> , <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mn>95</i:mn> <i:mi>%</i:mi> <i:mtext>CI</i:mtext> <i:mo>=</i:mo> <i:mo>−</i:mo> <i:mn>0.29</i:mn> </i:math> to 0.22, <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mi>P</k:mi> <k:mo>=</k:mo> <k:mn>0.204</k:mn> </k:math> ). Moreover, NLR was a stable predictor of outcome or response to treatment in such patients ( <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mtext>SMD</m:mtext> <m:mo>=</m:mo> <m:mn>1.01</m:mn> </m:math> , <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mn>95</o:mn> <o:mi>%</o:mi> <o:mtext>CI</o:mtext> <o:mo>=</o:mo> <o:mn>0.65</o:mn> </o:math> to 1.37, <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mi>P</q:mi> <q:mo><</q:mo> <q:mn>0.001</q:mn> </q:math> ); the higher the NLR, the worse the outcome. In addition, patients who underwent mechanical ventilation had higher levels of NLR compared to those who did not ( <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mtext>SMD</s:mtext> <s:mo>=</s:mo> <s:mn>0.93</s:mn> </s:math> , <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mn>95</u:mn> <u:mi>%</u:mi> <u:mtext>CI</u:mtext> <u:mo>=</u:mo> <u:mn>0.05</u:mn> </u:math> to 1.82, <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mi>P</w:mi> <w:mo>=</w:mo> <w:mn>0.03</w:mn> </w:math> ). However, NLR levels were not different among distinct GBS subtypes, so it could not distinguish among them. In conclusion, our analysis indicates that the NLR levels are highly elevated in patients with GBS. Therefore, the NLR has the potential to be used as a biomarker to inform diagnosis, prognosis, or treatment responses in GBS, and future studies are warranted.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it