Bibliographic record
Abstract
BACKGROUND: The cause of the "treatment-risk paradox" reported for patients with coronary disease is unknown; however, determining the factors that contribute to this paradox is essential to properly design quality improvement interventions. METHODS: Prospective cohort study enrolling consecutive patients with angiographically proved coronary disease between February 1, 2004, and November 30, 2005, in Alberta. RESULTS: One month after an angiogram, statins were being taken by 2436 (62.9%) of 3871 patients (mean age, 64 years). High-risk patients were less likely to be taking statins than lower-risk patients (55.8% vs 63.5%; crude odds ratio [OR], 0.72 [95% confidence interval {CI}, 0.57-0.92]; risk ratio [RR], 0.88 [95% CI, 0.79-0.97]), but this treatment-risk paradox was completely attenuated by adjusting for exertional capacity and depressive symptoms (OR, 0.98 [95% CI, 0.75-1.28]; RR, 0.99 [95% CI, 0.89-1.09]). These results were robust across drug classes: while high-risk patients were less likely to be taking angiotensin-converting enzyme inhibitors, aspirin, and statins (25.8% vs 32.3%; crude OR, 0.73 [95% CI, 0.56-0.95]; RR, 0.80 [95% CI, 0.65-0.97]), this association did not persist in the adjusted model (OR, 0.98 [95% CI, 0.72-1.33] [P = .87]; RR, 0.99 [95% CI, 0.79-1.20]). CONCLUSIONS: The treatment-risk paradox reported in administrative database analyses is attributable to clinical factors not typically captured in these databases (such as functional capacity and depressive symptoms). Interventions to address the treatment-risk paradox should recognize that patients with reduced functional capacity, depression, or both are at higher risk for underuse of these beneficial therapies and should target physicians and patients.
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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 | 0.000 | 0.000 |
| 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 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".