Paxlovid in British Columbia Interim real-world analysis
Bibliographic record
Abstract
Background: Therapeutics Letter 141 summarizes an interim analysis of the use of the antiviral medication Paxlovid (nirmatrelvir/ritonavir) in the Canadian province of British Columbia (BC). Paxlovid was authorized for emergency use by Health Canada in December 2021, in response to the COVID-19 pandemic. Methods: The Therapeutics Initiative’s (TI) Pharmacoepidemiology group examined the 28-day risk of Covid-19-related hospitalization or death from any cause using BC Ministry of Health datasets including PharmaNet, emergency department encounters, physician billing codes, discharge abstracts, PCR testing, and vaccination status. Patient follow-up data collected by community pharmacists was also assessed. Results: The review found that the evidence on Paxlovid is limited and of low certainty, due to issues with study design, conduct, and reporting. The available evidence suggests Paxlovid may reduce risk of hospitalization and death in some high-risk patients with COVID-19, but that the magnitude of this effect is uncertain and may be irrelevant to BC patients in 2023. Conclusions: The use of Paxlovid in BC should be guided by a careful consideration of the available evidence. Benefits have not been proven for lower-risk patients. PharmaCare’s program to record adverse drug events may lead to better methods of documentation in the future.
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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 | 0.035 | 0.111 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.006 |
| Bibliometrics | 0.005 | 0.011 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 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".