Bidirectional risk association between adenoid hypertrophy and laryngopharyngeal reflux: A systematic meta-analysis
Bibliographic record
Abstract
BACKGROUND: Adenoid hypertrophy (AH) and laryngopharyngeal reflux (LPR) are common, pathologically linked pediatric otolaryngological conditions; however, their causal relationship and mechanistic underpinnings are presently unclear. This study aimed to explore the association between AH and LPR in pediatric populations. METHODS: Two investigators independently performed literature screening across PubMed, Web of Science, and Cochrane Library databases. Newcastle-Ottawa Scale was employed to assess the methodological quality of cohort studies, as well as Appraisal tool for Cross-Sectional Studies was applied for evaluating cross-sectional investigations. The funnel plot was used to analyze publication bias. A meta-analysis of the extracted data was conducted by using R software platform (version 4.4.2, R Foundation, Vienna, Austria). RESULTS: A total of 18 studies (3 cross-sectional study and 15 cohort studies) were included, including 39,427 participants. Meta-analysis revealed elevated prevalence of LPR among children with AH, with a significantly increased risk of LPR in AH children (odds ratio = 10.53). Meanwhile, children underwent >1 time adenoidectomy (AT) exhibited increased risk of LPR (risk ratio = 9.43). All these data indicated LPR may play a role on AH. However, data from AT studies showed short-term symptoms of LPR could be alleviated (<1 year) after AT, but increased susceptibility to LPR (risk ratio = 2.03) was found with long-term follow-up (>10 years). These results suggested LPR was not only increase the risk of AH but also affected by AH. CONCLUSION: This study preliminarily validates the close association between AH and LPR. Future studies employing standardized diagnostic criteria are required to further elucidate the reciprocal relationship between AH and LPR, as the marked heterogeneity among earlier studies has primarily stemmed from variations in diagnostic methodologies.
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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 | 0.013 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.014 | 0.042 |
| Bibliometrics | 0.005 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".