Did Carotid Stenting and Endarterectomy Outcomes Change over Time in the Carotid Revascularization Endarterectomy Versus Stenting Trial? (S09.005)
Notice bibliographique
Résumé
Objective: To detect changes in the periprocedural outcomes in the Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) following carotid endarterectomy (CEA) and carotid artery stenting (CAS) to detect temporal changes, if present. Background Improvements in training and technique as well as improvements in selection of surgeons and interventionists had the potential to influence differential outcomes in CREST for the 2502 patients randomized between December of 2000 and mid-July of 2008. Design/Methods: Enrollment was divided into 3 consecutive epochs, each with approximately 834 patients. Rates for the primary outcome of stroke, death, and MI (SDMI) and for stroke and death (SD) during the periprocedural period were calculated. Poisson regression was used to adjust rates for age, sex, dyslipidemia, and symptomatic status, all of which were found to influence outcomes. Results: For CAS, there was a 26% decline in SDMI (6.2% a 4.6%) and a 35% decline in SD (5.5% a 3.6%). For both composite endpoints in CEA there was no consistent pattern. As CREST progressed, it enrolled younger patients, more men, and patients more likely to be dyslipidemic (all p Conclusions: Periprocedural safety for CAS improved over time in CREST. Changes were inconsistent for CEA. Improvements for CAS in part appear to reflect changes in patient selection related to age, sex, risk factors, and symptomatic status because adjustment for those variables attenuated the decline in rates. Linking rates to operator experience was not feasible because of the large number of new interventionists and surgeons entering CREST over time. Supported by: The National Institute of Neurological Disorders and Stroke (NINDS) and the NIH (R01 NS 038384) and by supplemental funding from Abbott Vascular Solutions (formerly Guidant). Disclosure: Dr. Howard has received personal compensation for activities with Bayer Healthcare and Abbott Labratories as a consultant. Dr. Howard has received research support from Amgen Inc. and Bayer Healthcare. Dr.Roubin has received royalty payments from Abbott Vascular and Cook Inc. Dr. Hopkins has received personal compensation for activities with Boston Scientific, Micrus, Abbott Labratories, W. L. Gore, BARD, Cordis Corporation, Memorial Healthcare System as a consultant an/or speaker.Dr. Hopkins holds stock and/or stock options in Micrus, Boston Scientific, AccessClosure, Valor Medical, Claret Medical, Inc., and Augmenix.Dr. Hopkins has received research support from Toshiba. Dr. Moore has received personal compensation for activities with WL Gore. Dr. Gray has received personal compensation for activities with Abbott Vascular as a consultant and a participant on an advisory board. Dr. Rosenfield has received personal compensation for activities with Abbott Vascular, Complete Conf Management, Contego Medical, LLC, and HCRI as a consultant.Dr. Rosenfield has received personal compensation for serving on the Board of Directors of VIVA Physicians. Dr. Rosenfield has received royalty or license fee or contractual rights payments from Angiograd (Cordis).Dr. Rosenfield holds stock and/or stock options in Contego Medical, LLC and Medical Simulation Corp. Dr. Rosenfield has received research support from Abbott Vascular. Dr. Katzen has received personal compensation for activities with Boston Scientific, W.L. Gore, and Medtronic as a consultant and particpant on an advisory board. Dr. Chakhtoura has nothing to disclose. Dr. Morrish has nothing to disclose. Dr. Ferguson has nothing to disclose. Dr. Hye has nothing to disclose. Dr. Shawl has received research support from Abbott, Medtronic, Boston Scientific, Johnson & Johnson, and Ev3. Dr. Harrigan has nothing to disclose. Dr. Voeks has nothing to disclose. Dr. Lal has nothing to disclose. Dr. Meschia has nothing to disclose. Dr. Brott has received personal compensation for activities with 3D Communications.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».