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Kawasaki Disease and Anti-Inflammatory Doses of Aspirin—A Complicated Relationship

2025· article· en· W4409140518 on OpenAlexaboutno aff
Matthew D. Elias

Bibliographic record

VenueJAMA Network Open · 2025
Typearticle
Languageen
FieldMedicine
TopicKawasaki Disease and Coronary Complications
Canadian institutionsnot available
Fundersnot available
KeywordsAspirinKawasaki diseaseMedicineDiseaseInternal medicine

Abstract

fetched live from OpenAlex

Kawasaki disease (KD) is an acute febrile childhood illness and is the leading cause of acquired heart disease among children in high-income countries.The primary concern is the development of coronary artery aneurysms (CAAs), particularly large or giant CAAs that increase the risk of morbidity and mortality.The mainstay of acute KD management is intravenous immunoglobulin (IVIG) and aspirin (acetylsalicylic acid), and timely treatment with IVIG has been shown to decrease the risk of developing CAAs.Even before the introduction of IVIG as an effective therapy for KD in the 1980s, conventional therapy included aspirin for its anti-inflammatory effects at higher doses and its antiplatelet effects at lower doses.This practice continues today despite years of controversy and ample debate in the KD community about anti-inflammatory dosages of aspirin in terms of both effectiveness and appropriate dosing.North American centers traditionally have used high-dose aspirin (80-100 mg/kg per day) in the acute phase of KD, while centers in Japan have used medium-dose aspirin (30-50 mg/kg per day), citing concerns about potential adverse effects of higher doses.[1][2][3] After defervescence, low-dose aspirin (3-5 mg/kg per day) is typically continued for the antiplatelet effects for 6 to 8 weeks after disease onset and longer in the presence of CAAs.Despite this established use of anti-inflammatory doses of aspirin, there is mounting evidence that medium-dose or high-dose aspirin in the acute phase does not impact CAA outcomes.Recently,

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.006
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.009
Threshold uncertainty score0.029

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.006
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0020.002
Science and technology studies0.0010.001
Scholarly communication0.0020.002
Open science0.0010.001
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0090.001

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.

Opus teacher head0.031
GPT teacher head0.321
Teacher spread0.290 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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