Regarding “Musculoskeletal Ultrasound Assessment of the Clinical Efficacy of the Combination of Acupressure and ‘Three Methods of Neck Movement (TCM)’ Therapy in the Treatment of Cervical Spondylosis” [Response to Letter]
Bibliographic record
Abstract
Range ConsiderationWe acknowledge the concern about the age range restriction (40-60 years) and its potential impact on the generalizability of our study results.While we noted the trend of younger onset of cervical spondylosis in our abstract, the decision to focus on the 40-60 age group was based on several considerations.First, there is a recognized difference in the classification of cervical spondylosis between domestic and international standards.Second, the typical age of onset for cervical spondylosis in China is between 30-60 years, whereas in international contexts, only spinal cord and nerve root cervical spondylosis have a clear proposal that the age of onset is over 40 years.Lastly, subjects over 60 years often have more underlying diseases, complicating the enrollment process.In alignment with the journal editors' recommendations, we chose to focus on the 40-60 age group. II. Follow-Up PeriodWe appreciate the observation regarding the 6-month follow-up period and agree that longterm efficacy assessment is crucial for chronic conditions like cervical spondylosis.Our study includes a 6-month followup to provide preliminary insights into treatment durability.We concur that extended observation periods are necessary for a comprehensive evaluation and plan to conduct further longitudinal studies.We also ensured that each participant was placed in a stable temperature chamber at 23-25°C during treatment to minimize the impact of temperature changes on the results. III. Single-Center Design and Ultrasound Operator ExpertiseWe recognize the limitations of a single-center study design and the variability in treatment protocols and expertise levels across different medical institutions.We are committed to pursuing multicenter collaborations in future research to enhance the generalizability of our findings.Regarding the use of musculoskeletal ultrasound, we ensured that all operators underwent professional skills training and passed assessments to use the equipment accurately.Each participant was examined by two trained and certified operators, and a third operator was involved in case of inconsistent results to ensure reliability. IV. Evaluation of Psychosocial DimensionsWe agree that a more extensive evaluation of psychosocial dimensions is necessary.While the McGill Pain Questionnaire and the Neck Disability Index (NDI) are primary outcome measures, they do not fully capture the broader psychosocial context.We plan to incorporate validated psychological assessment tools, such as the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), and the
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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 | 0.004 | 0.029 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.018 | 0.012 |
| Insufficient payload (model declined to judge) | 0.007 | 0.006 |
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".