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Record W2604512463

Are family physicians using the CHADS2 score

2011· article· en· W2604512463 on OpenAlexvenueaboutno aff
Douglas Klein, Max Levine

Bibliographic record

VenueCanadian Family Physician · 2011
Typearticle
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineWarfarinAtrial fibrillationMedical recordStroke (engine)Internal medicineDiabetes mellitusHeart failureRetrospective cohort studyCardiologyPhysical therapyEmergency medicine
DOInot available

Abstract

fetched live from OpenAlex

Objective To assess whether family physicians are using the CHADS2 (congestive heart failure, hypertension, age ≥ 75, diabetes mellitus, and stroke or transient ischemic attack) score in the decision to initiate warfarin therapy to prevent stroke in patients with atrial fibrillation. Design Retrospective analysis of the medical records of patients with atrial fibrillation. Setting Data were gathered from records at 3 clinics in a primary care network in Edmonton, Alta. Participants The medical records of patients with atrial fibrillation who were currently taking warfarin therapy. Main outcome measures Percentage of patients whose CHADS2 scores indicated warfarin therapy for stroke prophylaxis compared with the actual percentage of patients taking warfarin therapy. Data on patients’ age, number of medications, and number of comorbid conditions were also recorded. Results Among these patients, 7% had a CHADS2 score of 0, for which no warfarin therapy was indicated; 21% had a score of 1, for which either acetylsalicylic acid or warfarin was indicated; and 72% had a score of 2 or greater, for which warfarin therapy was indicated. About 80% of patients were taking medication to control their heart rate. Conclusion The CHADS2 score is not being used in all cases to assess the need for warfarin therapy for preventing stroke in patients with atrial fibrillation. The CHADS2 score might be of limited use because it is not sensitive enough to stratify patients clearly into high-, intermediate-, and low-risk groups. Although guidelines for stroke prevention should be followed, the CHADS2 portion of the guidelines might not be the most effective way to assess patients’ risk of stroke.

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)0.002
metaresearch head score (Gemma)0.017
Version: metacan-v3-hybrid-931329e0061cValidation 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 score0.015
Threshold uncertainty score0.030

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0020.017
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0010.001
Science and technology studies0.0010.000
Scholarly communication0.0010.001
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0060.001

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 head0.165
GPT teacher head0.296
Teacher spread0.131 · 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 designObservational
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

Citations1
Published2011
Admission routes2
Has abstractyes

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