Abstract P161: Improved Gender and Racial-Ethnic Disparities in the Management of Acute Myocardial Infarction. Experience from a Community Hospital Serving a Large Hispanic Population in USA
Bibliographic record
Abstract
Introduction: Disparities in medical therapies and revascularization procedures have been reported for women and Hispanics in the management of Acute Myocardial Infarction (AMI) in USA. Objectives: A paucity of recent data on this subject from facilities with a large Hispanic patient (pts) base motivated this study. Methods: Records of consecutive 525 pts (55% women, 289 of 525) admitted between 2005-2007 with a suspected AMI to a Southern California non-profit Community Hospital. Results: Race/ethnicity was unknown in 40 pts; 48%, 252 of 525, were Hispanic; 30 %, 155 of 525, Non Hispanic Whites and 14%, 78 of 525, African-Americans and Asians. No gender differences in age (66.9±14.8), diabetes, hypertension, dyslipidemia, medical insurance were found. Men had more AMI (93%, 219 of 236 v/s 51%, 147 of 289, p<0.001), death (7.6%, 18 of 238 v/s 3.8%, 11 of 289, p<0.05), smoking, CATH, PTCA and CABG than women. However, there were no gender or Hispanic ethnicity differences in the proportion of procedures performed when an AMI was confirmed (Fig1). Hispanic women (HW) showed no differences in death, AMI, CATH, CABG and Stress Test as compared to Non Hispanic White Women (NHWW) with the exception of PTCA (31%, 22 of 71, vs. 50%, 21 of 42, p <0.03). A trend (NS) for more AMI in NHWW and CABG in HW was noted. Non Hispanic Whites had more private/commercial insurance than Hispanics (61%, 95 of 155 vs. 32.1%, 81 of 252, p<0.01), regardless of gender. No differences were found in the composite (admission, discharge) use of ASA/Antiplatelets, B-blockers, ACEI /ARB and lipid lowering treatment. Conclusions: No Gender and Hispanic race/ethnicity disparities in the management of AMI were found for most services. HW received less PTCA than NHWW, difference that may be multifactorial. Medical insurance inequalities between Non Hispanic Whites and Hispanics persist but apparently did not affect the AMI care. It is uncertain if these results are applicable to facilities in USA with different socioeconomic, racial/ethnic mix or resources.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".