Positive Temporal Artery Ultrasound and Biopsy After 5 Months of High-Dose Glucocorticoids
Bibliographic record
Abstract
To the Editor: We read with interest the article by Majerovich et al describing the duration of glucocorticoid (GC) therapy and temporal artery biopsy (TAB) positivity in giant cell arteritis (GCA).1 Their results are noteworthy, indicating GC therapy does not appear to significantly affect TAB positivity to at least 6 weeks1; findings that the authors noted are also supported by our institution’s experience.2 It is our group’s opinion that GCA should be confirmed by biopsy and/or imaging (temporal artery or large-vessel), and patients with clinical diagnosis should be restricted to those with characteristic features for whom appropriate investigations were negative or nondiagnostic and alternative etiologies were excluded. Current GCA management consensus guidelines by the American College of Rheumatology (ACR) conditionally recommend obtaining a TAB within 2 weeks of starting oral GCs, compared to waiting longer than 2 weeks.3 We agree with Majerovich and colleagues1 that TAB, particularly in patients with cranial symptoms, can still be diagnostic beyond 2 weeks, especially if other objective methods of disease confirmation have not yet been attempted, or were done and were inconclusive. Temporal artery … Address correspondence to Dr. M.J. Koster, Associate Professor of Medicine, Division of Rheumatology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA. Email: koster.matthew{at}mayo.edu.
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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 | 0.001 | 0.012 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.010 | 0.010 |
| Insufficient payload (model declined to judge) | 0.003 | 0.002 |
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".