Impact of secondary amenorrhea on cardiovascular disease risk in physically active women: a systematic review protocol
Bibliographic record
Abstract
OBJECTIVE: The objective of this review is to assess the association between secondary amenorrhea in physically active women and cardiovascular disease risk. INTRODUCTION: It is well established that a woman's risk of cardiovascular disease greatly increases after menopause. The sharp decline in estrogen is seen as a causal factor. Exercise-induced secondary amenorrhea results in estrogen deficiency, which may lead to dysfunction in estrogen's cardioprotective pathways. Further, estrogen may be essential in a woman's endothelial adaptations to exercise. The impact of secondary amenorrhea on cardiovascular disease risk in premenopausal women is not well established. INCLUSION CRITERIA: This review will consider studies that include physically active women experiencing amenorrhea in any country. Only studies that present evidence of cardiovascular disease, alterations to cardiovascular physiology, or data on cardiovascular risk factors (eg, lipid profile changes) will be considered. The review will consider experimental or observational epidemiological study designs. METHODS: Searches will be conducted in CINAHL (EBSCOhost), the Cochrane Library, Embase (Ovid), MEDLINE (Ovid), SPORTDiscus (EBSCOhost), and Scopus from inception to present with no date or language limitations. Two independent reviewers will screen titles, abstracts, and full texts, appraise methodological quality, and extract data from studies. Where possible, studies will be pooled in a statistical meta-analysis in addition to subgroup analyses. Where pooling is not possible, the findings will be presented in narrative format. Certainty of the evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. REVIEW REGISTRATION: PROSPERO CRD42023360781.
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How this classification was reachedexpand
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 | 0.003 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.001 |
| Bibliometrics | 0.001 | 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 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
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 teacher head, 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".