Changes in doxylamine-pyridoxine dispensation in Ontario following media attention
Bibliographic record
Abstract
Objective To understand the possible association between media coverage and changes in the dispensation of doxylamine-pyridoxine in Canada. Design Cross-sectional time-series analysis using data from the IQVIA CompuScript database. Setting Ten Canadian provinces. Participants Family physicians, general practitioners, and obstetrician-gynecologists. Main outcome measures Data on the estimated total volume of doxylamine-pyridoxine prescriptions dispensed by retail pharmacists in Ontario and across Canada between July 2016 and May 2022 were used for a time-series analysis. Birth data obtained from Statistics Canada were used to adjust for pregnancy rates. Finally, the possible impact of media coverage in January 2018 on doxylamine-pyridoxine use was assessed with interventional autoregressive integrated moving average modelling, and dispensation rates of doxylamine-pyridoxine were reported overall and by prescriber specialty. Results Doxylamine-pyridoxine dispensation decreased by 1.2% (P=.015) overall in Ontario but did not change significantly (P=.064) across the rest of Canada. Out of 619,720 total doxylamine-pyridoxine prescriptions dispensed, 391,722 (63.2%) prescriptions were written by family physicians or general practitioners in Ontario, and there was a decline of 2.4% (P=.010) in the dispensation of doxylamine-pyridoxine based on prescriptions written by this group that lasted for 6 months before returning to previous dispensation rates. There was no significant change in the dispensation of doxylamine-pyridoxine based on prescriptions written by obstetrician-gynecologists (decline of 0.5%, P=.235) in Ontario. Conclusion Despite nationwide media attention questioning the efficacy of doxylamine-pyridoxine in early 2018, trends in dispensation rates of doxylamine-pyridoxine were only modestly affected and only in Ontario. Within Ontario, a small but significant reduction in doxylamine-pyridoxine dispensations was noted based on prescriptions from family physicians or general practitioners but not based on those written by obstetrician-gynecologists. Factors associated with the ongoing use of doxylamine-pyridoxine despite evidence of lack of benefit require further research.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| 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".