Association between mean intraocular pressure, disease stability and cost of treating glaucoma in Canada
Bibliographic record
Abstract
PURPOSE: A retrospective analysis determined the association between intraocular pressure (IOP) control levels (mean and last IOP) and disease stability, and the association between IOP and yearly treatment cost in primary open angle glaucoma (POAG). METHODS: Data were collected from POAG patients, referred to a tertiary glaucoma clinic. All IOP measurements, visual field mean deviation (VF) scores, physicians' impressions, and resources used (physician visits, procedures, and medications) were recorded and costed using standard resource unit cost lists from the Ministry of Health's perspective. Patients were categorized by the average VF score of their first three visits [mild (< 5 dB), moderate (> or = 5 dB to < 12 dB) and severe (> or = 12 dB)]. Pearson's r quantified the association between IOP control levels and stability, where stability was defined by the physician's subjective impression of the patient's disease. Spearman's rho was determined to quantify association between mean IOP and yearly treatment cost within VF categories. RESULTS: Four hundred and eleven charts were reviewed of which 265 were acceptable for analysis. A negative relationship was determined between the probability of reaching stability and mean IOP in all three VF severity groups. Pearson's r was -0.68 (p < 0.001), -0.72 (p < 0.001), and -0.52 (p < 0.001) for the mild, moderate, and severe groups, respectively. A similar correlation was determined between the last measured IOP and stability. Pearson's r was -0.49 (p < 0.001), -0.80 (p < 0.001), and -0.65 (p < 0.001) for the mild, moderate and severe groups, respectively. A positive relationship was reported between mean yearly costs and IOP. Spearman's rho between mean yearly costs and mean IOP was 0.11 (p = 0.28), 0.23 (p < 0.05), and 0.26 (p < 0.05) for each respective VF level. DISCUSSION AND CONCLUSION: Lower IOP control levels are associated with higher probabilities of stability. In addition, lower IOP control levels are associated with lower costs of managing POAG in patients either with moderate VF loss or with severe VF loss. Economic burden increased with increasing disease severity.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| 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".