Goals and Design of a Dedicated Tertiary Care Centre NMOSD/MOGAD Clinic
Bibliographic record
Abstract
ObjectiveTo review and share the process and design of patient clinic dedicated to the care of patients with Neuromyelitis Optica Spectrum Disorder (NMOSD) and Myelin Oligodendrocyte Antibody-Associated Disease (MOGAD). BackgroundPatients with NMOSD and MOGAD have time-sensitive and specific needs that may not be adequately addressed in a large, undifferentiated demyelinating disease clinic. This includes rapid assessment in suspected NMSOD relapses, arranging relapse therapy such as plasmapheresis, and enrolment in trials of putative therapies. Design/MethodsProviders with the greatest expertise and complement of NMOSD and MOGAD patients, in consultation with providers in other provincial centers, came to a consensus about patient criteria (suspected, probable, and confirmed MOGAD and NMOSD), triage acuity, visit frequency, transition from inpatient to clinic processes, Neuro-ophthalmology participation, trainee involvement, and nursing support to oversee treatment pathways. ResultsThe University of Calgary NMOSD/MOGAD clinic was developed to run once monthly staffed by three dedicated staff. Eligible patients are those with confirmed or probable seropositive or seronegative NMOSD, or MOGAD, including those with ADEM, cortical encephalitis, recurrent optic neuritis and/or myelitis AFTER appropriate investigations. Patients with suspected or newly confirmed NMOSD/MOGAD receiving acute relapse treatment requiring medication tapering and maintenance therapy, or those referred from Ophthalmology or Neurology actively relapsing and needing acute treatment guidance, will be deemed urgent. Patients with probable or newly confirmed MOGAD/NMOSD and a recent suspicious event successfully treated who may have already started a maintenance therapy, or patients with probable NMOSD in remission, but not on maintenance therapy will be deemed semi-urgent. ConclusionsWe believe focused NMOSD/MOGAD care directed through a dedicated clinic with appropriate staffing and processes will result in better outcomes and patient satisfaction. We will review clinic outcomes and issues at 6 months intervals after initiation.
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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 | 0.005 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.002 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.004 | 0.007 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.026 | 0.004 |
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".