Abstract 9791: Sex Disparities in Implantable Cardioverter Defibrillator (ICD) Outcomes: Findings From the Ontario ICD Database
Bibliographic record
Abstract
BACKGROUND: Sex disparities may exist in decisions to implant an ICD, complications and patient outcomes, but contributing factors are not fully elucidated. We determined if men and women who were referred or implanted with an ICD differed in their device use, complications, and outcomes. METHODS: We examined prospectively-enrolled patients referred for consideration of ICD implantation in Ontario between Feb 2007 to Jul 2010 in the Ontario ICD Database. Patients were followed for 45-day complications, and occurrence of ICD-delivered therapies (i.e., appropriate shock, appropriate therapy, and inappropriate therapy) and death within one-year follow-up. Multivariable-adjusted odds ratios (aOR) and hazard ratios (aHR) > 1.0 signified increased likelihood of implantation, complications, ICD-delivered therapies, or death in women. RESULTS: Of 6021 patients (4733 men) referred for ICD implantation, 1155 women (89.7%) and 4294 men (90.7%) received devices, with an overall aOR of 0.87 (95%CI; 0.69-1.10, p=0.24). Women were significantly more likely than men to have a minor (aOR 1.55; 95%CI; 1.09-2.20, p=0.014), major (aOR 1.78, 95%CI; 1.24-2.58, p=0.002), or any complication (aOR 1.50, 95%CI; 1.12-2.00, p=0.006). Among 5213 persons (4108 men) contributing 3,860 person-years of follow-up, there was a lower likelihood of appropriate ICD-delivered therapies in women. Adjusted HRs were 0.69 (95%CI; 0.51-0.93, p=0.015) for appropriate shock, 0.73 (95%CI; 0.59-0.90, p=0.003) for appropriate ICD-delivered therapy, and 0.97 (95%CI; 0.64-1.55, p=0.885) for inappropriate shock ( Figure ). Mortality did not differ among male and female ICD recipients: aHR=1.00 (95%CI; 0.64-1.55, p=0.988). CONCLUSIONS: ICD implantation rates were similar in men and women after referral to an electrophysiologist. Female ICD recipients exhibited higher rates of early complications and were less likely to experience appropriate shocks or antitachycardia therapy than men.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".