The interaction among sex, hemoglobin and outcomes in a specialty heart failure clinic.
Bibliographic record
Abstract
PURPOSE: Although anemia has recently been demonstrated to be a marker for poor outcomes in patients with congestive heart failure (CHF), the impact of sex on the prevalence and prognostic impact of anemia has not been adequately explored. Accordingly, the relationship among sex, anemia and outcomes in CHF was analyzed. SUBJECTS: Patients seen at a specialty CHF clinic from 1989 to 2001. METHODS: A retrospective analysis of prospectively collected data was performed using chi2 and Student's t tests to determine the association between anemia and mortality. Multivariate Cox proportional hazards models were used to measure the independent association of anemia with mortality in men and women. The World Health Organization definition of anemia (less than 130 g/L for men; less than 120 g/L for women) and the Centers for Disease Control and Prevention definition of anemia (less than 135 g/L for men, less than 120 g/L for women) were used, and hemoglobin was assessed as a continuous variable. RESULTS: There were 791 patients with CHF seen over a 12-year period (median age 69 years, median hemoglobin of 131 g/L [interquartile range 119 to 144 g/L]) and 34% were women. The demographics and treatments were similar for men and women, except that women were older (69 years versus 65 years, P<0.001), more likely to have a nonischemic etiology of CHF (P<0.001) or diastolic dysfunction (P<0.001), and lower creatinine clearances (P<0.001). Forty per cent of men and 35% of women were anemic using the World Health Organization definition. Anemia was associated with a one-year and five-year excess mortality in men (adjusted OR 1.7 [1.1 to 2.5] and 1.76 [1.2 to 2.7], respectively), but this was not observed in women (adjusted OR 1.2 [0.7 to 2.2] and 1.2 [0.7 to 2.1], respectively). CONCLUSIONS: Anemia is prevalent in heart failure and predicts mortality in men but not in women. Given this result, the authors recommend that randomized trials evaluating novel therapies for the correction of anemia in patients with heart failure should stratify their randomization by sex.
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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".