A Response to Smith et al.
Bibliographic record
Abstract
Dear Editors, We appreciate the opportunity to respond to Smith et al.’s letter regarding our gambling meta-review.1 We concur wholeheartedly with their amplification of the importance of addressing gambling problems among service members (SMs), a critical issue highlighted in our meta-review. As noted in our paper, from 2005 to 2018, the DoD dropped gambling screening items from the Health-Related Behaviors surveys because of consistent and low prevalences. Our meta-review concluded that using low sensitivity and specificity screening measures in populations with low prevalences leads to identifying giant haystacks with few needles (i.e., an overwhelming number of false positives and few actual cases). As we noted, when applying the best screening tools to the general SM population, “positive results would be incorrect 64-99% of the time,” which may potentially burden resources without commensurate benefits. We remain committed to our conclusion that until more accurate screening tools with high sensitivity and specificity become available, it remains prudent to limit screening efforts to specific settings with higher prevalences, such as those in the Air Force Alcohol and Drug Abuse Prevention and Treatment program or SMs seeking mental health services. Our study points out that for SMs with alcohol-related problems, positive results using the best screening tools (e.g., Problem Gambling Severity Index-Short Form and Massachusetts Gambling Screen-DSM-IV subscale) would be correct 68 to 76% of the time. We suggested a dual-phase screening process in these subpopulations: Initial screening to identify subclinical gambling or gambling disorder followed by a structured clinical interview to assess Diagnostic and Statistical Manual of Mental Disorders -5th Edition gambling disorder criteria. In conclusion, we echo the sentiment that addressing gambling problems among SMs is essential. However, we advocate for a cautious approach to screening, focusing resources on contexts where the benefits of detection outweigh the risks of massive false positives. None declared. Contract from the U.S. Air Force to Cherokee Insights, LLC; this activity was funded under subcontract 29700-0005, Item 3.3.1.1 to New York University. None declared. Not applicable. Not applicable. Not applicable. Not applicable. A.S. and R.E.H. drafted the response, and J.O. and A.M.S.S. provided input and editing.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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) | 0.002 | 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; both teacher heads agree on what is shown here.
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".