The Nordic Long-term OCD Treatment Study (NordLOTS): A Summary of the Diagnostic Workup and Acute Treatment Stages
Bibliographic record
Abstract
The NordLOTS rationale for a stepped-care study was that patients who received serotonin re-uptake inhibitors (SRI) were mainly CBT non-responders while RCTs examining the outcome of SRI were treatment naive. We argued that CBT non-responders may have an attenuated SRI response, and that continued CBT would be the preferable control contingency as we had reason to believe that CBT (particularly focusing on exposure and response prevention (ERP)) may still show some efficacy. A 3-year follow-up of all patients was added to inform on treatment durability. In NordLOTS, 269 step-1 participants had a pre-ERP average CY-BOCS score of 24.6, and completers (n = 241) of ERP treatment had a response rate (post ERP CY-BOCS ≤ 15 points) of 72.6% with a mean symptom reduction of 52.9%. Out of 69 non- or partial responders to step 1 ERP, 54 patients accepted step 2 randomization to continued ERP or sertraline (mean CY-BOCS = 27.3 and 25.2, respectively). Due to attrition, the final intent-to-treat sample included 50 participants (48% males). Twenty-one of 28 participants (75 %) completed continued ERP while 15 of 22 participants (69.2%) completed sertraline. The CY-BOCS total score examination revealed no differences between treatments (mean = 21.3 and 21.1, respectively) and response rates were 50.0% and 45.4%, respectively. Good step-1 ERP response rates, and equal response to step-2 sertraline or continued ERP showed that extended treatment may be worthwhile in pediatric OCD, and following our 269 participants yearly for three years will demonstrate if treatment durability is acceptable as well.
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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 | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 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".