Initial Consensus for the Management of Topical Steroid Withdrawal: A Delphi Study
Bibliographic record
Abstract
Abstract: Background: Topical steroid withdrawal (TSW) is a poorly defined condition thought to be related to prolonged use of topical corticosteroids. Currently, management guidelines for TSW do not exist. Objective: This study aimed to form expert consensus and initial management guidelines using the modified Delphi consensus approach. Methods: Our expert panel of 21 physicians and patient advocates assessed 72 pharmacologic and supportive management strategies for consensus over 2 survey rounds. Outcomes achieving ≥70% agreement or disagreement were defined as meeting endpoint consensus. Results: Final expert consensus included 12 outcomes, primarily focused on cessation of topical and systemic corticosteroids and psychosocial support. Additionally, our panel met consensus for dupilumab as a first-line systemic treatment. Conclusions: Here, we present initial guidelines for the management and treatment of TSW until further therapies can be investigated for future evidence-based 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 | 0.235 | 0.213 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.003 | 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".