From disease improvement to disease stability in patients with COPD: IMPACT post hoc analysis
Bibliographic record
Abstract
Rationale: Attaining disease stability (DS), a state of low disease activity, is a current unmet need for patients with COPD. Methods: The IMPACT study compared FF/UMEC/VI 100/62.5/25µg (N=4151) vs FF/VI 100/25µg (N=4134) and UMEC/VI 62.5/25µg (N=2070) in patients with moderate-severe (mod-sev) symptomatic COPD and high risk of exacerbation. In this post hoc analysis, DS was defined as a composite outcome at W52 (no mod/sev exacerbations, ≥−25mL change in FEV1, ≤1 change in CAT score vs W28) stratified by improvement due to treatment at W28 using the same 3 components of the composite (no mod/sev exacerbations, ≥0mL change in FEV1, ≤0 change in CAT score vs baseline). Adjusted risk ratios (aRR [95% CI]) for W28 improvement were calculated. Results: Of patients treated with FF/UMEC/VI, 1471 (35%) improved in the composite when assessed at W28 or W52 (Table). More (n=1234, 30%) did so at W28 (FF/UMEC/VI vs FF/VI [n=774, 19%], aRR [95% CI]: 1.58 [1.46-1.70]; vs UMEC/VI [n=448, 22%], aRR [95% CI]: 1.37 [1.25-1.51]). Of these 1234, 255 (21%) also maintained the DS composite at W52. Conclusion: Patients can achieve improvement in a composite endpoint of lung function, symptoms and exacerbations at 6 months after treatment and maintain the gain (DS) at W52. In this high-risk IMPACT population, patients receiving FF/UMEC/VI were more likely to achieve the composite endpoint vs dual therapy. Funding GSK (CTT116855/ NCT02164513 ). erj;66/suppl_69/PA5716/F1 F1 F1
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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 | 0.017 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.009 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.004 |
| Insufficient payload (model declined to judge) | 0.007 | 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".