Abstract P325: Utilization of Cardiac Rehabilitation in Eligible Medical Cardiac Patients
Bibliographic record
Abstract
Introduction: Cardiac rehabilitation (CR) is recommended for patients who suffer an acute coronary syndrome (STEMI, non-STEMI, or unstable angina), stable angina, or who receive a percutaneous coronary intervention (PCI). CR reduces both all-cause and cardiovascular mortality and reduces hospitalizations. Despite these benefits the rate of participation among eligible patients in the United States is low- estimated around 20%. Our aim is to identify the rate of participation among our patients, identify patient subsets with low levels of participation, and to identify and remove barriers to participation. Methods: We performed a review of all patients treated at a tertiary care hospital from February 2014 to January 2015 with a condition that qualifies for CR based on current ACC/AHA guidelines. We excluded patients with a surgical indication. We limited our search to patients residing in zip codes within 40 miles of a CR facility within our hospital system (five centers in southwest Virginia). Patients were considered to have participated in CR if they attended at least 1 session of phase two CR occurring within 1 year of hospitalization. Results: We identified 1910 eligible patients, of these 249 (13%) participated in cardiac rehabilitation. Those who participated in CR tended to be younger (mean age 65 versus 70 years), male (71% versus 59%), and nonsmokers (smoking rate 19% in participants versus 25% in nonparticipants). Those with ACS were most likely to participate (167 of 879 eligible patients, 19%), followed by stable angina (19 of 134, 14%) and PCI (63 of 897, 7%). Conclusion: The benefits of CR are substantial including enhanced quality of life and improved survival. We believe all eligible patients should be encouraged to participate in CR. The next phase of our analysis will include identification and removal of barriers to participation. We are actively educating providers on patient eligibility and the benefits of CR with an emphasis on underrepresented demographics (women, elderly, smokers, after PCI, etc).
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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 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
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.
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".