Characteristics of patient-reported worsenings of asthma and/or COPD and concordance with physician-reported exacerbations
Bibliographic record
Abstract
Background: Exacerbations of asthma and/or COPD are important clinical outcomes but reports of symptom worsening by patients and physicians may differ. Methods: NOVELTY ( NCT02760329 ) is an international observational study of patients with physician-assigned asthma and/or COPD. Patient-reported episodes of worsening (PREW) were recorded 3-monthly. Physician recording of exacerbations included information on start date, medications, and medical care. We evaluated characteristics of patients who reported any PREW during the last 3 months of the first follow-up year, by physician-reported exacerbations over the same period. Results: Among 5,214 patients with asthma and/or COPD, during the 3 month period, PREW were reported by 56%, 55% and 50% patients with asthma, asthma+COPD, and COPD, respectively. In contrast, an exacerbation was reported, respectively, for 9%, 16% and 12% of patients. Nearly half of PREW events without corresponding exacerbations were treated. Patients with PREW and no exacerbations (vs. both PREW & exacerbation) were more likely male, more frequently current smokers, had higher lung function, lower intensity of respiratory symptoms and fewer physician visits. They also exhibited different comorbidity profile, e.g. less GERD, allergy, bronchiectasis in asthma, less emphysema in COPD. Conclusion: Patients with asthma and/or COPD frequently report episodes of treated and untreated PREW without a concomitant diagnosis of exacerbation by their health-care provider. This highlights potential under-reporting of exacerbations in obstructive lung disease, particularly among patients with perceived milder disease or with fewer physician visits.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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".