Are There Socioeconomic Diaparities in Access to ABO Incompatible and Kidney Paired Donor Transplantation?
Bibliographic record
Abstract
Background: Lower income ESRD patients have markedly reduced access to living donor kidney transplantation (LDKT). Kidney paired donation (KPD) and ABO incompatible (ABOi) transplantation are important strategies to expand access to LDKT. We sought to examine access to KPD and ABOi transplantation as a function of median household income. Methods: We compared characteristics of all n=1,699 recipients of ABOi and KPD transplants to recipients of directed compatible LDKT (n=32,074) between 1998-2010 using SRTR data. We then stratified all LDKT recipients into quintiles based on their median household income and determined the association of median household income with ABOi or KPD transplantation among all LDKT recipients using multivariate logistic regression after adjustment for recipient age, gender, race, PRA, and ABO type. Results: KPD/ABOi recipients included more patients that were older, sensitized, African American, blood type O, highly educated, and with a higher median household income. After adjustment for biologic and sociodemographic factors, patients in the highest 2 quintiles of median household income (Q4 and Q5) had a 1.27 and 1.25 fold higher likelihood of KPD/ABOi transplantation compared to patients in the lowest income quintile (Q1) (Table). Conclusion: KPD and ABOi transplantation are innovative mechanisms to improve access to LDKT. These data suggest that these innovations remain less accessible to low income ESRD patients, who are known to have markedly reduced access to LDKT.Table: No Caption available.
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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 | 0.008 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 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".