Treatment patterns of extracorporeal photopheresis in steroid-refractory graft versus host disease: A delphi study
Bibliographic record
Abstract
Steroid-refractory GvHD (SR-GvHD) following allogeneic transplant is a major clinical challenge and is associated with substantial mortality [ 1 ]. While the European Society for Bone and Marrow Transplantation (EBMT) recommends ruxolitinib for second-line treatment of GvHD [ 2 ], some patients may experience side effects or refractoriness, and therefore require alternative treatment options [ 2 ]. However, there are no standardized treatment recommendations for SR-GvHD beyond ruxolitinib in Europe [ 2 ]. Extracorporeal photopheresis (ECP), a cell-based, immunomodulatory therapy, is quoted as a potential treatment option beyond second-line, in the EBMT guidelines [ 2 ]. ECP has been shown to be an effective and well-tolerated treatment for SR-GvHD [ 3 ]. Clinical evidence has limitations though, including few randomized studies and a lack of consensus on optimal treatment schedule [ 3 , 4 ]. A Delphi study was thus carried out to provide a descriptive account of clinical practice regarding ECP treatment patterns in SR-GvHD.
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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 | 0.007 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".