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Characteristics of Decedents in Medicare Advantage and Traditional Medicare

2016· article· en· W2413328575 on OpenAlex

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenueJAMA Internal Medicine · 2016
Typearticle
Languageen
FieldMedicine
TopicPalliative Care and End-of-Life Issues
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineMedicare AdvantageMedicare Part DMedicare Part BDemographyGerontologyMEDLINEHealth careNursingPaymentPrescription drugFinance

Abstract

fetched live from OpenAlex

Methods | Waiver for this study was obtained through Alberta Health Services for collection of aggregate data.Based on these various sources of recommendations, a guideline was formed (Box) and was approved by Alberta Health Services.This guideline led to a separate form being developed and issued by laboratory services.Physicians now had to identify the indication for testing vitamin D levels.Indications other than those identified in the guideline did not allow for testing of vitamin D levels.This new requisition was implemented on April 1, 2015.Before this date, for several years, the number of annual 25-hydroxy vitamin D assays was approximately 310 000 per year (ie, 1 in 14 Albertans).We measured the monthly number of vitamin D order requests before and after introducing a new procedure for ordering tests.Results | From April 1 to December 31, 2015, subsequent to the creation of a new ordering form, 20 609 vitamin D tests were ordered.During this 9-month period, one would have expected, based on historical data, that 256 027 tests would have been ordered.This intervention thus led to a 92.0%reduction in the number of vitamin D tests ordered, a savings of about $4 million USD per year ($3 million in the period studied thus far) (Figure).Although criteria-based interventions are susceptible to methods that manage to avoid adhering to the requirements, a rebound in test ordering has not been observed 9 months after implementation.Our laboratory ordering system is both paper-based and electronic; thus, this type of intervention can be used in many different systems.Discussion | Criteria-based approaches to the implementation of the Choosing Wisely recommendations have been examined in practice for other tests, including the commonly ordered tests for rheumatoid factor antibody and anti-nuclear antibodies, as well as advanced imaging (computed tomographic scan, bone scan, or magnetic resonance imaging) for spinal pain. 5,6 Using a criteria-based approach to test ordering not only reduces the number of tests that would be ordered but it does so without missing clinically relevant conditions.

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.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation 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 score0.075
Threshold uncertainty score0.864

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.003
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
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 head0.076
GPT teacher head0.386
Teacher spread0.311 · 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