98 Patient-reported, clinical and radiological factors associated with the result after non-surgical management of acute AC joint dislocations
Bibliographic record
Abstract
Background The treatment of Rockwood type III/V acromioclavicular(AC) joint dislocations is debated. The objective of this prospective cohort study was to investigate the association between demographical, clinical, patient-reported and radiological variables at baseline/6w with the result after 3m, 6m and 1y. Methods Inclusion criteria were patients aged 18–60 with acute AC joint dislocation and >50% superior displacement of the clavicle. Patients were treated non-surgically with 3m of home-based training and the option of delayed surgical intervention. The primary outcome was the Western Ontario Shoulder Instability Index(WOSI). Secondary outcome was surgery yes/no. Patients were evaluated at baseline and 6w, 3m, 6m and 1y after the injury. Demographical, clinical, patient-reported and radiological variables were investigated for association with the outcomes. A model to identify patients at risk of surgery was suggested. Results Ninety-five patients with Rockwood type III/V AC joint dislocation were included. Pre-injury participation in overhead/collision sports and reduced range of motion (ROM) at baseline were associated with reduced WOSI and increased risk of surgery. At 6w, reduced ROM, reduced WOSI and increased SPADI were associated with the outcomes. Radiological measurements were not associated with the result. At 6w, all patients eventually requiring surgery could be detected with a sensitivity of 100% and a specificity of 94% based on a SPADI score>30 and a ROM<=140 degrees in flexion/abduction. Conclusion ROM was the only factor consistently associated with both WOSI and risk of surgery. Six weeks after the injury, patients in need of surgery could be detected based on ROM and SPADI.
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| 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) | 0.003 | 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".