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Record W2280893780 · doi:10.1186/s12913-016-1910-8

Effects of longitudinal changes in Charlson comorbidity on prognostic survival model performance among newly diagnosed patients with hypertension

2016· article· en· W2280893780 on OpenAlexafffundabout
Peter Rymkiewicz, Pietro Ravani, Brenda R. Hemmelgarn, Finlay A. McAlister, Danielle A. Southern, Robin L. Walker, Guanmin Chen, Hude Quan

Bibliographic record

VenueBMC Health Services Research · 2016
Typearticle
Languageen
FieldMedicine
TopicChronic Disease Management Strategies
Canadian institutionsAlberta Health ServicesLibin Cardiovascular Institute of AlbertaUniversity of AlbertaUniversity of Calgary
FundersCanadian Institutes of Health ResearchAlberta Innovates - Health Solutions
KeywordsMedicineComorbidityProportional hazards modelHazard ratioAkaike information criterionMyocardial infarctionInternal medicineConfidence intervalEmergency medicineStatistics

Abstract

fetched live from OpenAlex

BACKGROUND: To assess the use of updated comorbidity information over time on ability to predict mortality among adults with newly diagnosed hypertension. METHODS: We studied adults 18 years and older with an incident diagnosis of hypertension from Alberta, Canada. We compared the prognostic performance of Cox regression models using Charlson comorbidities as time-invariant covariates at baseline (TIC) versus models including Charlson comorbidities as time-varying covariates (TVC) using Akaike Information Criterion (AIC) for testing goodness of fit. RESULTS: The strength of the association between important prognostic clinical variables and mortality varied by modeling technique; for example, myocardial infarction was less strongly associated with mortality in the TIC model (Hazard Ratio 1.07; 95% Confidence Interval (CI): 1.05 to 1.1) than in the TVC model (HR 1.20; 95% CI: 1.18 to 1.22). All TVC models slightly outperformed TIC models, regardless of the method used to adjust for comorbid conditions (individual Charlson Comorbidities, count of comorbidities or indices). The TVC model including all 17 Charlson comorbidities as individual independent variables showed the best fit and performance. CONCLUSION: Accounting for changes in patient comorbidity status over time more accurately captures a patient's health risk and slightly improves predictive model fit and performance than traditional methods using TIC assessment.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.032
metaresearch head score (Gemma)0.077
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.061
Threshold uncertainty score0.171

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0320.077
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0010.001
Open science0.0010.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.071
GPT teacher head0.365
Teacher spread0.294 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations4
Published2016
Admission routes3
Has abstractyes

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