Sex/gender predicts individual trajectories of change in patient-reported outcomes after implantable cardioverter-defibrillator
Bibliographic record
Abstract
Purpose: To study the change in Patient-Reported Outcomes (PROs) in the first six months following Implantable Cardioverter-Defibrillator (ICD) surgery to identify the direction and rate of change, explore individual trajectories of change, and identify predictors of those trajectories. PROSs are assessments provided directly by patients about various aspects of their health and quality of life. Methods: The study was grounded in the Wilson and Cleary conceptual framework of quality of life, and informed by the Patient-Reported Outcomes Measurement Information System domain framework. Using a prospective, longitudinal study design, measurements of patient-reported physical, mental and social health status were obtained prior to ICD implantation, and 2, 3, and 6 months following implantation. Individual growth modelling was conducted to analyse change within individuals and between groups. Results: Data were initially obtained from 171 people undergoing a first ICD implantation for primary or secondary indication at quaternary centres in Canada (55.5% response rate). Follow-up measures were obtained from 149 people at 1-month, 140 at 2-months, and 139 at 6-months after implantation (81.3% completion rate). Participants had differing physical, mental, and social PROs at baseline and,on average, demonstrated improvement, over time, in most indicators. At most measurement occasions, the participants' PROs remained lower than those of urban-dwelling Canadians aged 25 years or older. There was significant individual variability in most of the studied PROs, especially in the social domains Age, social support, employment, indication for implantation, shock history, or distance travelled to specialised medical services did not explain the variability in rate change. In contrast, women reported worse PROs initially (relative mean gender difference ranged from 4.5% to 24.7% for 6 of the 12 indicators). Yet, the women's rates of improvement on the indicators were significantly faster than those of men. Women equalled or exceeded the men's PROs at 6-month follow-up (relative mean gender difference ranged from 4.5% to 10.4%). Conclusions: Clinicallyimportant improvements were noted in most PROs in the first 6 months following ICD implantation. Men and women had different trajectories of change, and may benefit from gender-specific, appropriately timed, and targeted interventions to facilitate recovery and adaptation to living with an ICD.
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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 | 0.005 |
| 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 | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".