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Record W124855344

Effects of restrictive formularies in the ambulatory care setting.

2002· article· en· W124855344 on OpenAlexaff
Joel Lexchin

Bibliographic record

VenuePubMed · 2002
Typearticle
Languageen
FieldMedicine
TopicPharmaceutical studies and practices
Canadian institutionsYork University
Fundersnot available
KeywordsFormularyMedicinePrior authorizationAmbulatoryHealth careIntensive care medicineMEDLINEAmbulatory careQuality (philosophy)Family medicineNursingSurgery
DOInot available

Abstract

fetched live from OpenAlex

OBJECTIVE: To determine the consequences of restrictive formularies in the ambulatory care setting in 4 areas: overall drug expenditures, overall healthcare spending, changes in the quality of prescribing, and health outcomes. STUDY DESIGN: A MEDLINE search was conducted for English and French language articles, published between 1977-1999, that presented results in quantitative terms. Only articles from industrialized countries were used. METHODS: Information was extracted from each article in the following areas: time period of the study, geographic location and group of patients involved, outcome measurement(s), intervention, study design, and results. RESULTS: Poor methodologic quality made definitive conclusions difficult to draw in most areas. Prior authorization may be effective in controlling drug costs without increasing costs in other areas. Both desirable and undesirable therapeutic substitutions may take place when drugs are delisted from formularies. CONCLUSIONS: The use of restrictive formularies in the ambulatory care setting requires more rigorous research. Before changes are made in formularies, money needs to be set aside for research into short-term and long-term consequences of using restrictive formularies.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.031
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.005
Threshold uncertainty score0.026

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0050.031
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0000.001
Scholarly communication0.0010.001
Open science0.0000.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0020.000

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.

Opus teacher head0.038
GPT teacher head0.288
Teacher spread0.250 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations29
Published2002
Admission routes1
Has abstractyes

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