Initiation of controller medication in newly diagnosed asthma patients: Impact on economic resource utilization
Bibliographic record
Abstract
Introduction: To better understand the economic burden of asthma, we compared asthma-related direct costs among adults prescribed controller regimens. Methods: A cohort of newly diagnosed asthma patients (14-65 y/o), initiating a controller therapy for the first time between 1997 to 2007, was created from the health administrative database of British Columbia, Canada. Five cohorts of patients were created according to the way controller therapy was initiated: inhaled corticosteroid (ICS group), ICS/long-acting beta-agonist combination (ICS/LABA group), ICS+LABA in separate formulations (ICS+LABA group), leukotriene receptor antagonist (LRA group) or ICS+LRA in separate formulations (ICS+LRA group). Index Date (ID) was defined as the date controller medication prescribed. Direct cost of asthma in the post-ID year (2008 Canadian dollars) was calculated from the hospital, physician visits, and prescription records, adjusted for multiple covariates estimated from the pre-ID year. Results: 153,224 patients were included: 109,601 ICS; 34,184 ICS/LABA; 2,249 ICS+LABA; 6,289 LRA; 901 ICS+LRA. The average age was 37.7 and 61.0% were female. The average direct costs of asthma for the post-ID year for the ICS group was 265.2$. All other groups had higher incremental costs: ICS/LABA +$125.9, ICS+LABA +$218.2, LRA +$198.4, and ICS+LRA +$322.4 (all p<0.01). Older age, higher resource, and higher cumulative dose of rescue medicine use in the pre-ID year were predictors of resource use in the post-ID year (p<0.01). Conclusions: Initiation of ICS, as recommended by guidelines, was associated with the lowest costs than initiation of other controller or combination therapies.
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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 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".