2024 CSACI Annual Scientific Meeting Book of Abstracts
Bibliographic record
Abstract
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant disease burden.Oral corticosteroids (OCS) are frequently used to treat CRSwNP; however, OCS therapy is associated with increased risk of adverse events.Biologics are an effective option in managing CRSwNP and reducing need for OCS, yet OCS use prior to biologic initiation is poorly characterized.Therefore, this study aimed to describe patterns of OCS use among patients with CRSwNP in Canada prior to biologic use.Methods: This retrospective, real-world study leveraged IQVIA's Private Drug Plan claims database.Patients with CRSwNP (diagnosis inferred on longitudinal claims data) 24 months prior to biologic treatment initiation (index) between August 2020 and November 2023 were selected.OCS use and overexposure (total yearly dose of OCS ≥ 1,000 mg [maximum recommended total lifetime cumulative dose]) in the 24 months pre-index (analysis period) were described using mean (± standard deviation [SD]).Results: Overall, 747 patients were included; mean (SD) age was 51 (± 13) years, 48% were female.Over the 24-month analysis period, 81% of patients had ≥ 1 claim for OCS (mean [SD] 4.0 [5.0] claims per patient).Among those with known prescribers, OCS was prescribed by 1, 2 or ≥ 3 physician specialties in 62%, 31% and 7% of patients, respectively.Of those with ≥ 1 claim for OCS, mean (SD) dose per patient was 32 (± 17) mg/day; mean (SD) treatment duration was 77 (± 132) days.In total, 28% of patients had OCS overexposure 12-24 months pre-index, which increased to 39% in the 12 months pre-index.Conclusions: Prior to biologic initiation, 39% of patients with CRSwNP were overexposed to OCS and mean OCS treatment duration reached almost 3 months.Earlier consideration of escalated therapy, adherence to prescribed therapies, and improved communication amongst physicians and patients could reduce risk of OCS overexposure and improve patient care.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.004 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.653 | 0.526 |
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".