Does plasma exchange have a role in ANCA-associated vasculitis? Viewpoint 1: plasma exchange should not be used indiscriminately
Bibliographic record
Abstract
ANCA-associated vasculitis (AAV) is a heterogeneous autoimmune disease marked by varying organ involvement and outcomes. Plasma exchange, a method of removing native plasma and replacing it with crystalloid, albumin or donor plasma, can deplete autoantibodies and may help control autoimmune diseases rapidly. In AAV, several randomized controlled trials have been performed but, individually, had mixed results. The best data available, through meta-analysis, suggest the effects of plasma exchange in AAV are limited to improving kidney outcomes with a low likelihood of other benefits but also an increase in the risk of serious infections. As such, the use of plasma exchange in AAV should be limited to patients at risk of a poor kidney outcome as all others are more likely to experience harm than benefit. By estimating the risk of kidney failure and serious infections with and without plasma exchange, healthcare providers can help patients with AAV make informed choices about the use of plasma exchange.
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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 | 0.003 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".