Assessment of Juvenile Idiopathic Arthritis Outcomes and Place of Residence in Canada: Identifying Disparities in Care
Notice bibliographique
Résumé
Objectives Previous research has shown that demographic, health care system, socioeconomic, cultural, and ethnic factors, may be contributors to JIA outcomes.[1,2] We aimed to assess the association of social and environmental factors with JIA outcomes in Canada. Methods Data was collected by the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) National JIA Registry, a registry of children newly diagnosed with JIA that collects and shares longitudinal data on disease course and outcomes. Demographic and clinical characteristics, medications used, and physician and patient-reported outcome measures were obtained for patients enrolled over a 4-year period (February 2017-December 2021). Clinical outcomes were linked to neighborhood-level geographic and sociodemographic factors based on postal code and data from the 2021 Statistics Canada Census. For each patient, the sociodemographic and environmental variables are based on the dissemination area associated with their postal code. We assessed the attainment of two primary outcomes within 6 months of enrollment: 1) clinically inactive disease, as defined by Wallace criteria and 2) pain relief, defined as a pain score <1 reported by patients and parents in 21-point pain scales. Logistic regression was used to evaluate the association of sociodemographic variables with the outcomes of interest. Results A total of 641 patients were included. 41.2% of patients achieved inactive disease within 6 months of enrollment. Table 1 demonstrates associations between the primary outcomes and neighborhood-level data. Greater distance to nearest pediatric rheumatology center was associated with decreased likelihood of attaining inactive disease by 6 months. Every 100 km increase in distance decreased the odds of attaining inactive disease by 10% (OR 0.90, 95% CI 0.81-0.99, P = 0.026). By 6 months, 27.9% of patients and 34.6% of parents reported relief of pain. Higher dwelling density (number of dwellings per square kilometer of the dissemination area) was associated with decreased odds of attaining pain relief reported by the patient (OR 0.67, 95% CI 0.45-0.99, P = 0.043). Table 1: Associations between attainment of clinically inactive disease and pain relief in patients with JIA within 6 months and neighbourhood-level geographic and sociodemographic factors. Conclusion Among Canadian children newly diagnosed with JIA, greater distance to the nearest pediatric rheumatology center was associated with lesser attainment of inactive disease, and higher dwelling density was associated with lesser attainment of pain relief by 6 months. Further analysis will examine the possible role of diagnostic or treatment delays in explaining these relationships. [1.] Lewis KA. J Pediatr Nurs 2017;37: 13-21. [2.] Tesher MS. Curr Rheumatol Rep 2012;14:116-20. Best Abstract on Equity Diversity and Inclusion in Rheumatology Award
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 | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,006 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 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 ».