Bibliographic record
Abstract
<div> Early in the SARS-Cov-2 pandemic, modified clinical guidance recommended the provision of take-home methadone doses for those previously ineligible to facilitate social distancing. Following this change, studies reported improved treatment retention among patients granted expanded access to take-home doses. However, most patients resumed daily dispensed methadone within six months. Factors associated with the return to daily dispensed methadone remain unknown. Therefore, we conducted a population-based cohort study to identify patient and prescriber-related characteristics associated with return to daily dispensed methadone. Our study included all residents of Ontario, Canada who received daily dispensed methadone on March 21, 2020, and were then provided at least one take-home dose between March 22, 2020, and April 21, 2020. Follow-up time was divided into 14-day discrete time intervals. The primary outcome was return to daily dispensed methadone, defined as the first interval where a take-home dose was not dispensed. A multilevel discrete time survival model with a complementary log-log link function and random intercepts across prescribers to account for patient clustering by prescriber was used to approximate cause-specific hazard ratios. Within 26 weeks, 1,675 (58.5%) individuals were reverted to daily dispensed methadone. Person-level variables significantly associated with our primary outcome included occurrence of an emergency department visit during or before the interval of interest (HR = 1.27; 95% CI = 1.05, 1.55) and missed methadone dose(s) in the interval prior (HR = 1.59; 95% CI = 1.44, 1.76). Lastly, patients prescribed methadone by a high-volume (top 20<sup>th</sup> percentile) opioid agonist treatment prescriber had an increased hazard of return to daily dispensed methadone compared to those prescribed methadone by a low-volume (50<sup>th</sup> percentile) prescriber (HR = 1.44; 95% CI = 1.14, 1.83). While patient characteristics that may indicate clinical instability, such as recent history of missed methadone dose(s) were associated with return to daily dispensed methadone, prescriber OAT client volume was also be associated this outcome. </div>
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.259 | 0.010 |
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; both teacher heads agree on what is shown here.
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".