Levodopa‐Carbidopa Intestinal Gel Improves Dyskinesia in Parkinson's Disease: Post Hoc Analysis from the <scp>COSMOS</scp> Study
Bibliographic record
Abstract
BACKGROUND: Dyskinesia is a debilitating complication of dopaminergic therapy in advanced Parkinson's disease. OBJECTIVES: To evaluate the effect of levodopa-carbidopa intestinal gel (LCIG) on dyskinesia burden. METHODS: This is a post hoc analysis of the retrospective, observational COmedication Study assessing Mono- and cOmbination therapy with levodopa-carbidopa inteStinal gel (COSMOS; NCT03362879). Change in dyskinesia was assessed by LCIG treatment group (monotherapy, daytime monotherapy, polytherapy), baseline dyskinesia duration (<4 vs. ≥4 hours), and dyskinesia severity (troublesome vs. non-troublesome). Correlations between changes in dyskinesia and patient-reported outcomes (Parkinson's Disease Questionnaire-8 [PDQ-8], Parkinson's Disease Sleep Scale-2 [PDSS-2], non-motor symptoms scale [NMSS]) were assessed using Spearman correlation coefficients. The Unified Parkinson's Disease Rating Scale IV measured dyskinesia duration (Item 32), severity (Item 33), and pain (Item 34). Data were collected cross-sectionally at a single study visit. RESULTS: Over 50% (202/369) of LCIG-treated patients experienced improvement in dyskinesia severity. Improvements in dyskinesia duration and severity were noted in all treatment groups. The proportion of patients with troublesome dyskinesia and amount of "Off" time significantly decreased from baseline to study visit, regardless of baseline dyskinesia burden (P < 0.01); dyskinesia duration improved only in the ≥4-hour subgroup (P < 0.01). In the ≥4-hour subgroup, dyskinesia duration correlated positively with PDQ-8; dyskinesia severity correlated positively with PDQ-8 and PDSS-2; and dyskinesia pain correlated positively with PDQ-8, PDSS-2, and NMSS. CONCLUSION: LCIG led to reductions in dyskinesia severity, regardless of baseline dyskinesia burden. Dyskinesia duration improved in patients with high dyskinesia burden but not in those with low dyskinesia burden.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.013 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".