Race and Socioeconomic Differences Associated With Changes in Statin Eligibility Under the 2013 American College of Cardiology/American Heart Association Cholesterol Guidelines
Notice bibliographique
Résumé
Background— The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines expanded eligibility criteria for statins. We examined race and socioeconomic differences associated with these changes. Methods and Results— This was an observational study of adults between 40 and 75 years of age using data from the National Health and Nutrition Examination Surveys between 2005 and 2012. Change in eligibility for statins was assessed based on the third adult treatment panel criteria and the 2013 ACC/AHA guidelines. Differences relating to self-reported race, income, education, and insurance status were assessed in models that were adjusted for age and each of the other factors. Statin eligibility increased among all race, education, and income groups. Becoming newly eligible for statins was more likely for black people (25.8% newly eligible; adjusted odds ratio, 3.8; P <0.001), people of other races (18.7%; adjusted odds ratio, 2.5; P <0.001), those with no more than high-school education (17.3%; adjusted odds ratio, 1.7; P =0.001), and those with no health insurance (17.6%; adjusted odds ratio, 1.5; P <0.001) compared with white people (14.5%), those who completed college (13.0%), and those with health insurance (15.6%). Income differences were not significant after adjusting for age, race, and education. These differences were driven by the prevalence of elevated predicted cardiac risk and diabetes mellitus. Among the US adults who were newly eligible for statins, 12.4 million (66.3%) were nonwhite, had lower education or lower income, and 3.0 million (16.1%) had no health insurance. Race and socioeconomic differences in statin eligibility were more pronounced under the 2013 ACC/AHA guidelines than under third adult treatment panel. If treatment disparities remain unchanged, the 2013 ACC/AHA guidelines increase the number of US adults who are eligible but do not receive statins by 3.0 million nonwhites, 3.6 million with no more than high-school education, and 4.1 million in the lowest 2 income quartiles. Conclusions— The 2013 ACC/AHA guidelines increase statin eligibility most among adults with nonwhite race, socioeconomic disadvantage, and no health insurance. Without improving access to healthcare, the potential gains from expanding indications for cardioprotective medications will not be realized.
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 distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 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 tête enseignante, 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 ».