Trends in Socioeconomic Status–related Differences in Mortality among People with Chronic Obstructive Pulmonary Disease
Bibliographic record
Abstract
RATIONALE: Previous studies have demonstrated that people of higher socioeconomic status (SES) have better chronic obstructive pulmonary disease (COPD) health outcomes than those of lower SES. Mortality of people with COPD has decreased over the last decade; however, it is not known if all individuals with COPD have benefitted equally. OBJECTIVE: The objective of the current study was to examine the impact of SES on mortality trends of individuals with COPD. METHODS: We conducted a population-based study using health administrative data from Ontario, Canada, between 1996/7 and 2011/12. Individuals with COPD were identified using a previously validated case definition. SES was determined using average household income of the individual's neighborhood as per the Canadian Census. Trends in standardized COPD mortality rates among different SES quintiles were observed over time. MEASUREMENTS AND MAIN RESULTS: Overall, age- and sex-standardized mortality of people with COPD decreased from 5.7% (95% confidence interval [CI], 5.5-5.8) in 1996/7 to 3.7% (95% CI, 3.6-3.8) in 2011/12, representing a 35% relative decrease. The mortality difference between the lowest and highest income quintiles increased from 67 per 10,000 individuals in 1996/7 to 86 per 10,000 individuals in 2011/12, representing a 28% relative increase (P < 0.001). CONCLUSIONS: Mortality in people with COPD has decreased faster in people with the highest compared with the lowest SES, causing increased disparity between rich and poor. Further study and strategies are needed to explore and address factors responsible for this increasing disparity in the COPD population.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".