Predictive Value of Severe Symptoms for Residual Disease After Transitioning From High to Low Disease Activity in Axial Spondyloarthritis: A Longitudinal Study
Bibliographic record
Abstract
OBJECTIVE: To investigate whether very high disease activity (VHDA) status or severe symptoms when in HDA state predict residual disease after achieving inactive disease/low disease activity (ID/LDA) in axial spondyloarthritis (axSpA). METHODS: Prospective data from the SpA-Net registry were used. HDA was defined as an Axial Spondyloarthritis Disease Activity Score (ASDAS) ≥ 2.1, and ID/LDA as ASDAS < 2.1. VHDA (predictor 1) was defined as ASDAS > 3.5, and severe symptoms when in HDA state (predictor 2) as a score ≥ 6/10 for fatigue, back pain, and/or physical function. Residual disease (outcome) was defined as presence of ≥ 1 patient-experienced (fatigue, back pain, and/or physical function ≥ 4/10) or objective disease indicator (active peripheral manifestations, active psoriasis, elevated C-reactive protein, or physician global assessment) after achieving ID/LDA. Associations between either predictor and residual disease were investigated using logistic regression. RESULTS: Overall, 133 patients (58 [43.6%] female, mean age 48.8 [SD 14.5] years) were included. At the HDA timepoint, 16 (12%) patients had VHDA status and 107 (80.5%) experienced severe symptoms. At the ID/LDA timepoint, prevalence of patient-experienced and objective residual disease was 70.7% (n = 94/133) and 54% (n = 37/68), respectively. VHDA status when in HDA state was not associated with either form of residual disease after achieving ID/LDA. Severe symptoms were associated with patient-experienced residual disease (odds ratio 5.09, 95% CI 1.76-14.71), but not objective residual disease. CONCLUSION: Severe symptoms when in HDA state predict patient-experienced, but not objective, residual disease in axSpA, whereas VHDA status does not predict either form. These findings may aid in anticipating residual disease and guiding management.
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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 | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".