Abstract P091: Temporal Trends in Incidence of Acute Myocardial Infarction and Revascularization in People With and Without Mental Illness
Bibliographic record
Abstract
Objective: The objective of this study was to evaluate the temporal trends in the incidence of acute myocardial infarction (AMI) and receipt of revascularization procedures in people with and without mental illness. Hypothesis: Individuals with mental illness will have higher rates of AMI, and lower rates of revascularization compared to people without mental illness. Methods: We did a population-based study using provincial administrative data from April 1, 1998 until March 31, 2009. We identified individuals 20 years of age and older as having mental illness (psychotic disorder [PD] or mood disorder [MD]) based on physician billing claims and hospitalization data, and compared them to those without mental illness by this definition. We identified incident AMI using a validated algorithm applied to hospitalization data. We used procedure codes to identify receipt of cardiac catheterization, coronary artery bypass grafting (CABG), or percutaneous transluminal coronary angioplasty (PTCA) in those with incident AMI. Rates were age-adjusted using the 2001 Canadian census population to perform direct standardization. Relative change over time was calculated by comparing rates in 2009 to rates in 1998. Results: A total of 3,639,480 subjects were included, of whom 576,411 (15.8%) had a mood disorder only, 38,116 (1.0%) had a psychotic disorder only, and 72,430 (2.0%) had both a MD and PD. People with MD were more likely to be female, whereas those with PD were older, than the other mentally ill and non-mentally ill populations. Incidence of AMI was highest in people with PD (210 per 100,000 in 2009) and lowest in people without mental illness (160 per 100,000 in 2009), however, incidence of AMI decreased over time in all groups. Use of catheterization decreased over time in people with MD (19% relative decrease) and PD (25% relative decrease), while increasing in people without mental illness (10.8% relative increase). Use of PTCA increased in all groups except people with PD (21.1% relative decrease). Conclusions: Incidence of AMI decreased over time in people with and without mental illness, however, people with mental illness consistently had a higher incidence of AMI compared to individuals without mental illness. Use of catheterization and PTCA increased in people without mental illness while decreasing in people with PD over the study period.
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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 | 0.000 | 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".