RESUMEN
The exchange of comments, opinions, and arguments in blogs, forums, social media, wikis, and review websites has transformed the Web into a modern agora, a virtual place where all types of debates take place. This wealth of information remains mostly unexploited: due to its textual form, such information is difficult to automatically process and analyse in order to validate, evaluate, compare, combine with other types of information and make it actionable. Recent research in Machine Learning, Natural Language Processing, and Computational Argumentation has provided some solutions, which still cannot fully capture important aspects of online debates, such as various forms of unsound reasoning, arguments that do not follow a standard structure, information that is not explicitly expressed, and non-logical argumentation methods. Tackling these challenges would give immense added-value, as it would allow searching for, navigating through and analyzing online opinions and arguments, obtaining a better picture of the various debates for a well-intentioned user. Ultimately, it may lead to increased participation of Web users in democratic, dialogical interchange of arguments, more informed decisions by professionals and decision-makers, as well as to an easier identification of biased, misleading, or deceptive arguments. This paper presents the vision of the Web of Debates, a more human-centered version of the Web, which aims to unlock the potential of the abundance of argumentative information that currently exists online, offering its users a new generation of argument-based web services and tools that are tailored to their real needs.
RESUMEN
BACKGROUND: The long-term outcome of rheumatoid arthritis (RA) patients who in clinical practice exhibit persistent moderate disease activity (pMDA) despite treatment with biologics has not been adequately studied. Herein, we analyzed the 5-year outcome of the pMDA group and assessed for within-group heterogeneity. METHODS: We included longitudinally monitored RA patients from the Hellenic Registry of Biologic Therapies with persistent (cumulative time ≥ 50% of a 5-year period) moderate (pMDA, 3.2 < DAS28 ≤ 5.1) or remission/low (pRLDA, DAS28 ≤ 3.2) disease activity. The former was further classified into persistent lower-moderate (plMDA, DAS28 < 4.2) and higher-moderate (phMDA, DAS28 ≥ 4.2) subgroups. Five-year trajectories of functionality (HAQ) were the primary outcome in comparing pRLDA versus pMDA and assessing heterogeneity within the pMDA subgroups through multivariable mixed-effect regression. We further compared serious adverse events (SAEs) occurrence between the two groups. RESULTS: We identified 295 patients with pMDA and 90 patients with pRLDA, the former group comprising of plMDA (n = 133, 45%) and phMDA (n = 162, 55%). pMDA was associated with worse 5-year functionality trajectory than pRLDA (+ 0.27 HAQ units, CI 95% + 0.22 to + 0.33; p < 0.0001), while the phMDA subgroup had worse 5-year functionality than plMDA (+ 0.26 HAQ units, CI 95% 0.18 to 0.36; p < 0.0001). Importantly, higher persistent disease activity was associated with more SAEs [pRLDA: 0.2 ± 0.48 vs pMDA: 0.5 ± 0.96, p = 0.006; plMDA: 0.32 ± 0.6 vs phMDA: 0.64 ± 1.16, p = 0.038]. Male gender (p = 0.017), lower baseline DAS28 (p < 0.001), HAQ improvement > 0.22 (p = 0.029), and lower average DAS28 during the first trimester since treatment initiation (p = 0.001) independently predicted grouping into pRLDA. CONCLUSIONS: In clinical practice, RA patients with pMDA while on bDMARDs have adverse long-term outcomes compared to lower disease activity status, while heterogeneity exists within the pMDA group in terms of 5-year functionality and SAEs. Targeted studies to better characterize pMDA subgroups are needed, in order to assist clinicians in tailoring treatments.