Treatment Patterns, Outcomes and Healthcare Resource Utilization of Obstructive Hypertrophic Cardiomyopathy in England
Notice bibliographique
Résumé
AIMS: Describe patient characteristics, treatment patterns, clinical outcomes, healthcare resource utilization (HCRU) and medical costs associated with patients who were diagnosed with obstructive hypertrophic cardiomyopathy (HCM) in clinical practice in England. METHODS AND RESULTS: This observational, retrospective, cohort study of adults who were diagnosed with obstructive HCM in routine clinical practice in England used electronic health records from Clinical Practice Research Datalink (CPRD) GOLD/Aurum and linked Hospital Episode Statistics (HES) databases (1 April 2007 to 30 October 2020). Adults (≥18 years at index date) with at least one diagnosis code (ICD-10, Read, SNOMED, or OPCS) indicative of HCM with ≥1 year of continuous registration in CPRD, data of acceptable research quality and eligibility for HES linkage were included. Outcomes from the obstructive HCM cohort were stratified by New York Heart Association (NYHA) class at baseline and during follow-up. Owing to the paucity of NYHA coding, patients with obstructive HCM and no record of NYHA class were assigned a proxy NYHA classification using an algorithm that considered patient symptoms and treatments. The study included 6440 patients in the overall HCM cohort with a mean follow-up duration of 4.84 [standard deviation (SD): 2.95] years. The study population was predominantly male (61.9%) and white (79.1%), with a mean (SD) age of 61.02 (15.61) years. The proportion of patients with obstructive HCM who had a pre-specified prior medical condition relevant to understanding disease burden increased with higher NYHA class (66.5% vs. 83.0% for NYHA class I and NYHA class II+, respectively), as did the proportion of patients with at least one baseline active prescription for cardiovascular-related medication. Among patients with at least one record of a prescription for the treatment of symptomatic obstructive HCM, 41.7% experienced a treatment change during the follow-up period. Atrial fibrillation or flutter, ischaemic stroke and heart failure were the most observed clinical events among patients in the obstructive HCM cohort, and the first in-study incidence of these events increased with higher NYHA class. Total HCRU costs per patient-year increased from £3033 to £4517 for NYHA classes I and II+, respectively, with secondary care costs consistently being the main driver in the obstructive HCM cohort. CONCLUSIONS: Obstructive HCM is associated with a large clinical and economic burden in England, and this burden increases with higher NYHA class. These findings support the need for new and more effective strategies for the management of HCM.
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 | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| 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 ».