Evaluating the impact of sling fiber preservation during POEM
Bibliographic record
Abstract
We appreciate the interest of Nabi et al.1 in our paper to evaluate the efficacy of sling fiber preservation during Peroral endoscopic myotomy (POEM).2 We acknowledge their concern that a major limitation of our study is the reliance on patient-reported symptoms to evaluate outcomes. However, patient-reported outcomes remain crucial in achalasia management, as POEM aims to alleviate symptoms rather than cure the disease. In our study, the sling fiber preservation group had a longer gastric myotomy length, which has been shown to improve the distensibility of the GE junction.3 Preservation of the sling fibers, along with a longer gastric myotomy, likely contributes to better GE junction opening while maintaining the angle of His. This may explain why the sling fiber preservation group demonstrated better Eckardt scores and lower GERD-Q scores compared to the conventional POEM group. Furthermore, a recent meta-analysis also showed that sling fiber preservation reduces the incidence of post-POEM GERD symptoms.4 These findings reinforce our conclusions.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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".