Letter by McAlister and Ezekowitz Regarding Article, “Temporal Trends and Variation in Early Scheduled Follow-Up After a Hospitalization for Heart Failure: Findings From Get With the Guidelines-Heart Failure”
Bibliographic record
Abstract
HomeCirculation: Heart FailureVol. 9, No. 6Letter by McAlister and Ezekowitz Regarding Article, "Temporal Trends and Variation in Early Scheduled Follow-Up After a Hospitalization for Heart Failure: Findings From Get With the Guidelines-Heart Failure" Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessLetterPDF/EPUBLetter by McAlister and Ezekowitz Regarding Article, "Temporal Trends and Variation in Early Scheduled Follow-Up After a Hospitalization for Heart Failure: Findings From Get With the Guidelines-Heart Failure" Finlay A. McAlister, MD, MSc Justin A. Ezekowitz, MBBCh MSc Finlay A. McAlisterFinlay A. McAlister Division of General Internal Medicine University of Alberta Edmonton, Alberta, Canada Canadian VIGOUR Centre University of Alberta Edmonton, Alberta, Canada Justin A. EzekowitzJustin A. Ezekowitz Division of Cardiology University of Alberta Edmonton, Alberta, Canada Canadian VIGOUR Centre University of Alberta Edmonton, Alberta, Canada Originally published13 Jun 2016https://doi.org/10.1161/CIRCHEARTFAILURE.116.002980Circulation: Heart Failure. 2016;9:e002980To the Editor:In their recent publication, DeVore et al demonstrated an increase between 2009 and 2012 in the proportion of heart failure patients who were scheduled for outpatient follow-up within 7 days of discharge.1 Because continuity of care has been shown to be associated with less healthcare utilization (hospitalizations, emergency department visits) and better patient outcomes,2,3 it seems reasonable to hypothesize that one of the factors contributing to continued poor outcomes for patients with chronic diseases such as heart failure is fragmentation. We have previously shown that (in Canada) early follow-up after a hospitalization or emergency department visit for heart failure with physicians familiar with a particular patient is associated with lower readmission rates than early follow-up with any physician.4,5 Are the investigators able to determine what proportion of early follow-up appointments in Get With The Guidelines-Heart Failure hospitals were planned to be with a physician who had been involved with the patient's care either before or during the index hospitalization? We think that continuity of care is one of the fundamental building blocks for any high-performing healthcare system and that the current guideline's emphasis on prompt follow-up after hospitalizations or emergency department visits may lead to system changes that neglect the importance of continuity.Finlay A. McAlister, MD, MScDivision of General Internal MedicineUniversity of AlbertaEdmonton, Alberta, CanadaCanadian VIGOUR CentreUniversity of AlbertaEdmonton, Alberta, CanadaJustin A. Ezekowitz, MBBCh MScDivision of CardiologyUniversity of AlbertaEdmonton, Alberta, CanadaCanadian VIGOUR CentreUniversity of AlbertaEdmonton, Alberta, CanadaDisclosuresNone.References1. DeVore AD, Cox M, Eapen ZJ, Yancy CW, Bhatt DL, Heidenreich PA, Peterson ED, Fonarow GC, Hernandez AF. Temporal trends and variation in early scheduled follow-up after a hospitalization for heart failure: findings from Get With The Guidelines-Heart Failure.Circ Heart Fail. 2016; 9:e002344. doi: 10.1161/CIRCHEARTFAILURE.115.002344.LinkGoogle Scholar2. Hussey PS, Schneider EC, Rudin RS, Fox DS, Lai J, Pollack CE. Continuity and the costs of care for chronic disease.JAMA Intern Med. 2014; 174:742–748. doi: 10.1001/jamainternmed.2014.245.CrossrefMedlineGoogle Scholar3. van Walraven C, Oake N, Jennings A, Forster AJ. The association between continuity of care and outcomes: a systematic and critical review.J Eval Clin Pract. 2010; 16:947–956. doi: 10.1111/j.1365-2753.2009.01235.x.CrossrefMedlineGoogle Scholar4. McAlister FA, Youngson E, Bakal JA, Kaul P, Ezekowitz J, van Walraven C. Impact of physician continuity on death or urgent readmission after discharge among patients with heart failure.CMAJ. 2013; 185:E681–E689. doi: 10.1503/cmaj.130048.CrossrefMedlineGoogle Scholar5. Sidhu RS, Youngson E, McAlister FA. Physician continuity improves outcomes for heart failure patients treated and released from the emergency department.JACC Heart Fail. 2014; 2:368–376. doi: 10.1016/j.jchf.2014.03.006.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails June 2016Vol 9, Issue 6 Advertisement Article InformationMetrics © 2016 American Heart Association, Inc.https://doi.org/10.1161/CIRCHEARTFAILURE.116.002980PMID: 27296398 Originally publishedJune 13, 2016 PDF download Advertisement SubjectsEpidemiologyHeart Failure
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 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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.002 |
| 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".