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The Cost Implications of Less Tight Versus Tight Control of Hypertension in Pregnancy (CHIPS Trial)

2016· article· en· W2514908712 on OpenAlexafffundabout
Rashid Ahmed, Amiram Gafni, Eileen K. Hutton, Zheng Hu, Eleanor Pullenayegum, Peter von Dadelszen, Évelyne Rey, Susan Ross, Elizabeth Asztalos, Kellie E. Murphy, Jennifer Menzies, Johanna Sanchez, Wessel Ganzevoort, Michael Helewa, Shoo K. Lee, Terry Lee, Alexander G. Logan, Jean‐Marie Moutquin, Joel Singer, Jim G. Thornton, Ross Welch, Laura A. Magee

Bibliographic record

VenueHypertension · 2016
Typearticle
Languageen
FieldMedicine
TopicPregnancy and preeclampsia studies
Canadian institutionsUniversity of ManitobaSunnybrook HospitalSunnybrook Health Science CentreCentre for Advancing Health OutcomesSickKids FoundationUniversity of TorontoProvidence Health CareUniversity of AlbertaUniversité de MontréalHospital for Sick ChildrenUniversity of British ColumbiaProvidence Health Care Research InstituteHealth Sciences CentreMount Sinai Hospital
FundersCanadian Institutes of Health ResearchSheffield Teaching Hospitals NHS Foundation TrustIWK Health CentreUniversitair Medisch Centrum GroningenMaastricht Universitair Medisch CentrumUniversity of South CarolinaEast Carolina UniversityUniversity of WarwickDebreceni EgyetemUniversidade Federal do Rio de JaneiroLondon Health Sciences CentreYale University
KeywordsMedicineConfidence intervalRandomized controlled trialPregnancyBlood pressureGestational hypertensionGestational agePediatricsObstetricsGestationInternal medicine

Abstract

fetched live from OpenAlex

UNLABELLED: The CHIPS randomized controlled trial (Control of Hypertension in Pregnancy Study) found no difference in the primary perinatal or secondary maternal outcomes between planned "less tight" (target diastolic 100 mm Hg) and "tight" (target diastolic 85 mm Hg) blood pressure management strategies among women with chronic or gestational hypertension. This study examined which of these management strategies is more or less costly from a third-party payer perspective. A total of 981 women with singleton pregnancies and nonsevere, nonproteinuric chronic or gestational hypertension were randomized at 14 to 33 weeks to less tight or tight control. Resources used were collected from 94 centers in 15 countries and costed as if the trial took place in each of 3 Canadian provinces as a cost-sensitivity analysis. Eleven hospital ward and 24 health service costs were obtained from a similar trial and provincial government health insurance schedules of medical benefits. The mean total cost per woman-infant dyad was higher in less tight versus tight control, but the difference in mean total cost (DM) was not statistically significant in any province: Ontario ($30 191.62 versus $24 469.06; DM $5723, 95% confidence interval, -$296 to $12 272; P=0.0725); British Columbia ($30 593.69 versus $24 776.51; DM $5817; 95% confidence interval, -$385 to $12 349; P=0.0725); or Alberta ($31 510.72 versus $25 510.49; DM $6000.23; 95% confidence interval, -$154 to $12 781; P=0.0637). Tight control may benefit women without increasing risk to neonates (as shown in the main CHIPS trial), without additional (and possibly lower) cost to the healthcare system. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01192412.

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 machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.005
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.031
Threshold uncertainty score0.062

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0030.005
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0010.000
Open science0.0010.000
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0030.000

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 head0.092
GPT teacher head0.283
Teacher spread0.190 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

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".

Quick stats

Citations13
Published2016
Admission routes3
Has abstractyes

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