Tuft resorption in patients with psoriatic arthritis
Bibliographic record
Abstract
• Tuft resorption is an important radiographic feature of psoriatic arthritis (PsA), yet its clinical significance remains inadequately characterized. • Forty percent of the patients in our cohort were observed to have tuft resorption on plain radiographs of the hands and feet. • Tuft resorption is a marker of severe disease. • Advanced disease-modifying anti-rheumatic drugs provide a protective effect against the development of tuft resorption. Tuft resorption (TR) is an important radiographic feature of psoriatic arthritis (PsA). We aimed to define the prevalence of TR in patients with PsA, the clinical and radiographic features associated with it, and the risk factors for its occurrence. We included patients with PsA followed at our prospective observational cohort. We defined TR as resorptive changes in the terminal tufts of the fingers or toes. We used generalized estimating equations to characterize clinical and radiographic features cross-sectionally associated with TR. We used multivariate Cox regression analysis to identify factors associated with the development of TR. Of the 1303 patients included in the study, 526 (40.4%) were observed to have TR, of whom 181 (34.4%) developed it during follow-up. TR was associated with older age (OR 1.49, p <0.01), longer duration of PsA (OR 1.03, p<0.01), higher radiographic damaged joint count (OR 1.02, p=0.04), axial disease (OR 1.73, p <0.01), and the number of systemic disease-modifying anti-rheumatic drugs (DMARDs) used (OR 1.27, p<0.01). Male sex (HR 1.54, p=0.01), vertebral osteopenia (HR 1.39, p=0.02), and use of non-steroidal anti-inflammatory drugs (HR 1.43, p=0.03) were associated with the development of TR. Use of biologic and targeted synthetic DMARDs was protective (HR 0.70, p=0.05), although not significant at the 5% level. TR is a common radiographic feature of PsA. It is associated with more severe disease, including peripheral and axial radiographic damage.
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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 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".