The use of oral corticosteroids and the risk of death from Chronic Obstructive Pulmonary Disease (COPD) /
Bibliographic record
Abstract
We investigated the use of oral corticosteroids (OCS) among patients with chronic obstructive pulmonary disease (COPD) and the subsequent risk of death from all causes, COPD, cardiac problems, and pneumonia. We identified an incident cohort of 2050 patients with COPD using the Saskatchewan Health databases. We matched 668 case patients who died with 6742 controls with respect to date of entry into the cohort. A nested case-control analysis was then conducted using conditional multivariate regression. The matched adjusted rate ratio (RR) of all cause mortality for any use of OCS was 1.48 (95% CI 1.18--1.84). An increased risk of death was also shown with cumulative dose (RR 1.17; 95% CI 1.08--1.25) and average yearly dose (RR 1.31; 95% CI 1.19--1.43). A dose-related increase in the adjusted rate ratios for cumulative OCS doses above 250 mg was observed. The risk is particularly evident among patients filling prescriptions for OCS in the 12 months before death. An increased risk of death from COPD was found, but no significant association was found for cardiac and pneumonia mortality. Although the results suggest the use of OCS increases the risk death among COPD patients, the possibility of confounding by indication and channelling may have influenced the results.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".