Thiazolidinediones and the risk of incident congestive heart failure among patients with type 2 diabetes mellitus
Bibliographic record
Abstract
BACKGROUND: Clinical trials suggest that thiazolidinediones (TZDs) may increase the risk of congestive heart failure (CHF). However, their effect on the risk of incident CHF in unselected populations has not been thoroughly investigated. METHODS: Using data from the UK's General Practice Research Database, we conducted a case-control study within a population-based cohort of patients with type 2 diabetes. Cases were identified by a clinical diagnosis of incident CHF and were then classified as possible or probable cases using prescription data. A 90-day drug exposure window was used in the primary analysis, which compared patients prescribed TZDs with those with no prescriptions for anti-diabetic medications. RESULTS: We identified 3405 incident cases (2632 probable and 773 possible) of CHF and 32,042 corresponding controls. TZDs were prescribed in 6.4% of cases and 6.3% of controls. Prescription of TZDs was associated with an increased rate of possible or probable CHF (adjusted rate ratio (RR) = 1.24, 95% CI = 1.01, 1.54 and adjusted RR = 1.24, 95% CI = 0.98, 1.58, respectively). Similar results were obtained when using a 180-day exposure window (RR = 1.38, 95% CI = 1.11, 1.72 and RR = 1.44, 95% CI = 1.12, 1.84, respectively). CONCLUSIONS: Given the totality of the evidence from this and previous studies, the probability of an increased risk for CHF with these agents remains high. However, any increase in CHF risk associated with TZDs may be lower than previously reported.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| 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, unvalidatedLabeled directly by 2 models reading the full record.
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".