Determinants of Health-related Quality of Life in Adults with Congenital Heart Disease
Bibliographic record
Abstract
OBJECTIVE: To examine health-related quality of life (HR-QoL) of adults with congenital heart disease (CHD). DESIGN: The HR-QoL of a large consecutive series of adults with CHD was prospectively studied using the Medical Outcome Study-Short Form 36. RESULTS: Except for very young men who report normal health, young adults describe poor health and exercise limitations relative to their peers in the community. In addition, middle-aged men report fatigue, psychological distress, impaired social functioning, and disability because of emotional difficulties. Among structurally defined subgroups, palliated and repaired cyanotic groups describe poor health. Patients with unoperated and palliated cyanotic lesions and men with repaired cyanotic defects or unoperated shunts also report exercise intolerance. Current cyanosis emerged as an important influence on HR-QoL. Patients with acquired cyanosis report poor health, exercise intolerance, fatigue, psychological difficulties, and social impairment. Chronic cyanosis was associated with only patient reports of poor health, exercise limitations, exercise-related disability, and social difficulties. Although adults with repaired cyanotic defects report poor health, no other HR-QoL deficits were reported by acyanotic patient groups. Pulmonary hypertension and rhythm disorders also influenced specific HR-QoL domains. Although gross structural and pathophysiologic factors influenced perceived health and exercise ratings, these variables were relatively poor predictors of self-reported health status and exercise capacity. CONCLUSIONS: Many adults with CHD do not meet normative expectations for perceived health status and exercise tolerance. The principal determinants of self-reported health status and perceived exercise tolerance in adults with CHD are not known. Gender differences in outcome require further investigation.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".