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Record W4417223881 · doi:10.1053/j.ajkd.2025.09.023

Representation of Older Patients Receiving Maintenance Dialysis in Randomized Controlled Trials: A Meta-epidemiologic Study

2025· article· en· W4417223881 on OpenAlexaff
Kevin Wang, Zoe A. Bamber, Lonnie Pyne, Arrti Bhasin, Michael D. Walsh, Rathika Krishnasamy, Glenn M. Chertow, Roberto Pecoits-Filho, Scott Klarenbach, Stephanie Thompson, David Collister

Bibliographic record

VenueAmerican Journal of Kidney Diseases · 2025
Typearticle
Languageen
FieldMedicine
TopicDialysis and Renal Disease Management
Canadian institutionsOntario Stroke NetworkMcMaster UniversityUniversity of Alberta
Fundersnot available
KeywordsDialysisRepresentation (politics)Randomized controlled trialMEDLINEKidney disease

Abstract

fetched live from OpenAlex

Randomized controlled trials (RCTs) provide high-quality evidence that informs the safety and efficacy of interventions. However, many RCTs lack representation of populations that may have differences in treatment effects.1 Age is an important consideration in RCTs because older adults have different pharmacology, multimorbidity, polypharmacy, and health care utilization2-4 and therefore may modify treatment effects. Older adults have also been historically under-represented in clinical trials, with many factors contributing, including participation barriers such as physical, functional, or cognitive impairments.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Direct model labels (unvalidated)

Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.

Model armCategoriesStudy designConfidence
gemmaMetaresearchMeta-epidemiology (broad)
Domain: Methods · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Observationallow
gptMetaresearchMeta-epidemiology (broad)
Domain: Methods · Genre: Empirical
About the Canadian research system: no · About a Canadian topic: no
Observationalmedium
models agreeAgreement compares identical category sets and study designs across arms.

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.131
metaresearch head score (Gemma)0.246
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch, Meta-epidemiology (narrow), Meta-epidemiology (broad)
Consensus categoriesnone
DomainCandidate signal: Methods · Consensus signal: none
Study designCandidate signal: Meta-analysis · Consensus signal: Meta-analysis
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.998
Threshold uncertainty score0.695

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.1310.246
Meta-epidemiology (narrow)0.0020.002
Meta-epidemiology (broad)0.0140.038
Bibliometrics0.0040.006
Science and technology studies0.0010.001
Scholarly communication0.0060.004
Open science0.0030.003
Research integrity0.0040.003
Insufficient payload (model declined to judge)0.0040.000

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.

Opus teacher head0.030
GPT teacher head0.354
Teacher spread0.324 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Labeled directly by 2 models reading the full record.

Study designObservational
DomainMethods
GenreEmpirical

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".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

Explore more

Same venueAmerican Journal of Kidney DiseasesSame topicDialysis and Renal Disease ManagementCategoryMetaresearchFrench-language works237,207