Abstract 18655: Impact of New Guidelines on Atrial Fibrillation Pattern Classification: The Women’s Health Study
Bibliographic record
Abstract
Background: Recent US guidelines have updated atrial fibrillation (AF) pattern definitions, reclassifying patients who undergo successful cardioversion within 7 days of AF onset as paroxysmal rather than persistent. The impact of this reclassification on AF pattern designation and risk factor profiles in patients with AF is unknown. Methods: We examined all participants with confirmed, new-onset AF among 34,636 women who were aged ≥45 years and free of AF and cardiovascular disease at baseline within the Women’s Health Study. All women were classified by AF type using both 2006 and 2014 ACC/AHA AF guideline definitions. AF type was classified as the most sustained form within 2 years of initial diagnosis. Risk factor profiles of patients reclassified by the 2014 guidelines were then compared to patients where AF pattern classification remained unchanged. Results: During a median follow-up of 19.2 years, 1493 women developed incident AF. Application of the 2006 AF guidelines identified 998, 313 and 182 women with paroxysmal, persistent and permanent AF, respectively. Using the 2014 AF guidelines, 107 women with persistent AF (34.2%) were reclassified to paroxysmal. Compared to women classified as persistent by both guidelines, those reclassified to paroxysmal by the 2014 guidelines were younger and had a lower prevalence of hypertension; but had similar weight and BMI (Table). Compared to women classified as paroxysmal by both guidelines, the women reclassified to paroxysmal were again younger but had a higher weight and BMI. Other cardiac risk factors did not differ significantly across AF patterns (Table). Conclusions: Using 2014 AF guidelines definitions, AF pattern was reclassified in a significant number of persistent AF patients. The risk factor profile of the reclassified women differed with respect to age, hypertension and BMI; known risk factors for AF progression. Selected AF pattern definition may influence results of future studies on AF progression.
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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 | 0.002 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 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".