Abstract 5: Regional Variation in Recommended Treatments for Ischemic Stroke and TIA: Get With The Guidelines-Stroke, 2003-2010
Bibliographic record
Abstract
Background: Prior studies find regional variation in the use of secondary stroke prevention treatments. We determined whether guideline-recommended stroke treatments vary by region for patients treated at Get With The Guideline (GWTG)-Stroke hospitals. Methods: Receipt of guideline-recommended interventions (acute IV-tPA, antihypertensive medications, antithrombotics, diabetes medications, anticoagulants for atrial fibrillation, lipid-lowering medications at discharge and smoking cessation) in addition to weight loss education were compared by region among eligible ischemic stroke and TIA patients. GEE models compared regional differences for each intervention adjusted for patient demographics, medical history and hospital characteristics. Results: There were 991,995 stroke or TIA admissions (South 37%, Northeast 27.6%, Midwest 19.3%, West 15.9%). Receipt varied by region: tPA ranged from 58.2-67.8%; antihypertensives 87.4-91.1%; antithrombotics 95.6-96.8%; diabetes meds 80.9-84.5%; anticoagulants 90.6-92.5%; lipid-lowering meds 72.5-75.7%; smoking cessation 89.8-92.7%; and weight loss education 49.3-54.7%. In adjusted analyses, the largest differences were in tPA and anticoagulant use (lower rates in the South and Midwest vs. the Northeast, Figure). Interventions tended to be less frequently provided in the Midwest vs. the Northeast. Conclusion: Although receipt of many recommended interventions is high, there are regional differences among patients treated at GWTG-stroke hospitals. As the hospitals participated in the same quality improvement program, the reasons for the differences are unclear and require further investigation.
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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) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".