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Record W4387389302 · doi:10.1016/j.mayocp.2023.08.006

Mayo Clinic Consensus Report on Membranous Nephropathy: Proposal for a Novel Classification

2023· article· en· W4387389302 on OpenAlexaff
Sanjeev Sethi, Laurence H. Beck, Richard J. Glassock, Mark Haas, An S. De Vriese, Tiffany Caza, Elion Hoxha, Gérard Lambeau, Nicola M. Tomas, Benjamin Madden, Hanna Dêbiec, Vivette D. D’Agati, Mariam P. Alexander, Hatem Amer, Gerald B. Appel, Sean J. Barbour, Fernando Caravaca‐Fontán, Daniel Cattran, Marta Casal Moura, Domingos O. d’Avila, Renato George Eick, Vesna D. Garovic, Eddie L. Greene, Loren P. Herrera Hernandez, J. Charles Jennette, John C. Lieske, Glen S. Markowitz, Karl A. Nath, Samih H. Nasr, Cynthia C. Nast, Antonello Pani, Manuel Praga, Giuseppe Remuzzi, Helmut G. Rennke, Piero Ruggenenti, Dario Roccatello, María José Soler, Ulrich Specks, Rolf A.K. Stahl, Raman Deep Singh, Jason D. Theis, Jorge A. Velosa, Jack F.M. Wetzels, Christopher G. Winearls, Federico Yandián, Ladan Zand, Pierre Ronco, Fernando C. Fervenza

Bibliographic record

VenueMayo Clinic Proceedings · 2023
Typearticle
Languageen
FieldMedicine
TopicRenal Diseases and Glomerulopathies
Canadian institutionsToronto General HospitalUniversity of TorontoUniversity of British Columbia
FundersMayo Clinic
KeywordsMembranous nephropathyAntigenAutoantibodyMedicineImmunohistochemistryImmunofluorescenceSerologyPathologyBiopsyKidney diseaseKidneyImmunologyComputational biologyGlomerulonephritisAntibodyInternal medicineBiology

Abstract

fetched live from OpenAlex

Membranous nephropathy (MN) is a pattern of injury caused by autoantibodies binding to specific target antigens, with accumulation of immune complexes along the subepithelial region of glomerular basement membranes. The past 20 years have brought revolutionary advances in the understanding of MN, particularly via the discovery of novel target antigens and their respective autoantibodies. These discoveries have challenged the traditional classification of MN into primary and secondary forms. At least 14 target antigens have been identified, accounting for 80%-90% of cases of MN. Many of the forms of MN associated with these novel MN target antigens have distinctive clinical and pathologic phenotypes. The Mayo Clinic consensus report on MN proposes a 2-step classification of MN. The first step, when possible, is identification of the target antigen, based on a multistep algorithm and using a combination of serology, staining of the kidney biopsy tissue by immunofluorescence or immunohistochemistry, and/or mass spectrometry methodology. The second step is the search for a potential underlying disease or associated condition, which is particularly relevant when knowledge of the target antigen is available to direct it. The meeting acknowledges that the resources and equipment required to perform the proposed testing may not be generally available. However, the meeting consensus was that the time has come to adopt an antigen-based classification of MN because this approach will allow for accurate and specific MN diagnosis, with significant implications for patient management and targeted treatment.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.004
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.493
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.004
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.001

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.

Opus teacher head0.075
GPT teacher head0.362
Teacher spread0.287 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreEmpirical

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".

Quick stats

Citations44
Published2023
Admission routes1
Has abstractyes

Explore more

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