Impact of Enhanced External Counterpulsation on Canadian Cardiovascular Society Angina Class in Patients with Chronic Stable Angina: A Meta‐analysis
Bibliographic record
Abstract
STUDY OBJECTIVE: To evaluate the true magnitude of benefit from enhanced external counterpulsation (EECP) by determining the effect of EECP on Canadian Cardiovascular Society (CCS) angina class in patients with chronic stable angina. DESIGN: Meta-analysis of 13 prospective studies that evaluated patients with stable angina and reported adequate data on CCS angina class. PATIENTS: A total of 949 adult patients with stable angina who underwent EECP treatment. MEASUREMENTS AND MAIN RESULTS: A systematic literature search of studies published between 1950 and February 2009 was performed. Studies were included for meta-analysis if they were reported in the English language, included human subjects, had a prospective study design, and reported adequate data on CCS angina class. The EECP treatment consisted of 35 sessions-1 hour/day, 5 days/week, for 7 weeks. Improvement in angina class was reported as the weighted proportion of patients improving by at least one CCS class from before to after EECP treatment. Heterogeneity was assessed by performing subgroup analyses and using the Cochran Q statistic. Publication bias was assessed by inspection of funnel plots and the Egger bias statistic. Among the 13 studies incorporating 949 patients, angina class was reduced by at least one CCS score in 86% of the patients (95% confidence interval 82-90%, Q statistic p=0.008]. Inspection of funnel plots showed some asymmetry, but the Egger bias statistic showed no publication bias (p=0.97). CONCLUSION: The results of our meta-analysis call for further long-term studies to determine the place of EECP therapy in the management of chronic stable angina. Currently, EECP therapy should be considered for patients with stable angina who are refractory to or not suitable for invasive therapy and/or medical management.
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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 | 0.012 | 0.025 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.012 | 0.042 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| 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".