P1‐034: A systematic review of Canadian and American cost‐of‐illness studies in dementia
Bibliographic record
Abstract
Estimates of the annual cost of dementia range into the billions of dollars. The objective of this study was to conduct a systematic review of published cost-of-illness (COI) studies in Canada and the United States, as well as to synthesize the conclusions of these studies into a set of common themes about the cost of dementia. Medline, CINAHL, EconLit, AMED, and the Cochrane Library were searched from inception to October 2009 for English-language COI studies. Other types of economic studies (cost-benefit, cost-effectiveness, and cost-utility analyses) were excluded from the review. Articles retrieved in the literature search were screened for inclusion using two levels of screening: (1) title and abstract and (2) full text. Data were extracted from articles that passed both levels of screening. Extracted data included information on study author(s), design, study participants, cost data, and sponsorship. Content analysis was used to synthesize the major conclusions of the extracted COI studies into a set of common themes about dementia cost. Nine hundred fifty-one articles were retrieved in the literature search and data were extracted from 46 articles. All except three articles reported American data. Most articles pertained to AD. Cost estimates varied considerably across articles. Sources of variation were differences in study populations and heterogeneity of COI methodologies (e.g., types of included costs, methods of calculating indirect costs). Despite cost variability, the extracted studies contained several common themes about the cost of dementia. Themes included general observations about dementia cost, cost drivers in dementia, caregiver cost, items that may lower dementia cost, social service cost, Medicare and Medicaid cost, and cost comparisons with other diseases. The content of each of the common themes could serve as the basis for policy-oriented research. However, authors of COI articles tended to focus on reporting the cost of dementia as an end in itself. Given methodological heterogeneity, there was no way to ascertain which (if any) of the articles actually reported the true cost of dementia.
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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 | 0.023 | 0.116 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.010 | 0.010 |
| Bibliometrics | 0.033 | 0.039 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.006 | 0.004 |
| Open science | 0.003 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.008 | 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".