HIV-related diarrhea: Measurement issues and the role of lactose intolerance
Bibliographic record
Abstract
Introduction. This thesis had four principal objectives: (1) to identify and review the validation of existing measures of HIV-related diarrhea used in clinical trials; (2) to determine the effect of a moderate dose of lactose on the stool weight in HIV-related chronic non-infectious diarrhea (CNID); (3) to evaluate the usefulness and feasibility of further study of breath testing (BT) to diagnose lactase deficiency (LD) in this population; (4) to prospectively compare several measures of HIV-related diarrhea to provide preliminary data on their validity. Conclusions. Studies 1 and 4: Tools currently being used for the measurement of HIV-related diarrhea are varied but have reasonable face validity only. Preliminarily, stool frequency and stool form seem useful; further work is needed to determine a definitive measure of HIV-related diarrhea. Study 2: Lactose ingestion does not worsen HIV-related diarrhea, regardless of underlying LD. Ingestion of lactose-containing dairy products should not be discouraged in this population. Study 3: BT to diagnose LD is of limited usefulness in this population; further study in this area is not feasible. Methods. Separate studies address these objectives. Study 1 is a review of the literature using Medline. Study 2 is a double-blind, randomized, crossover, non-inferiority trial of HIV-infected individuals with CNID. Study 3 is a preplanned subgroup analysis of the participants in Study 2. Study 4 tests the correlations between various measures of diarrhea used in Study 2. Results. Study 1: In clinical trials of HIV-related diarrhea, the most frequent measures were stool frequency, form and duration. Validation of common measures of HIV-related diarrhea was poor. Study 2: The mean difference in stool weight after lactose ingestion compared to placebo was -41.3 g (upper 95% confidence limit less than the non-inferiority boundary). Study 3: The mean difference in stool weight between the two study periods in the LD group was statistically different but likely clinically unimportant compared to the lactase present group. The smallest sample size was 183 for a new study of the specificity of BT. Study 4: Subject self-report of stool frequency underestimated the results obtained prospectively. Models including both study day stool form and stool frequency best predicted diarrhea severity.
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
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 | 0.012 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
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.
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".