A183 ANXIETY IMPACTS HEALTH-RELATED QUALITY OF LIFE AND HOSPITALIZATIONS IN PATIENTS WITH CIRRHOSIS
Bibliographic record
Abstract
Psychological distress is common in patients with cirrhosis. Depression has a significant effect on health-related quality of life (HRQoL), adaptive coping, functional status and mortality. The effect of anxiety on HRQoL and clinical outcomes is not as well understood. 1. Determine the prevalence of anxiety in cirrhosis and its association with clinical outcomes 2. Inform a rapid cirrhosis-specific anxiety screening tool by identifying multivariate predictors of anxiety using relevant clinical variables and subcomponents of the Hospital Anxiety and Depression Scale (HADS) Patients 18–80 years old with a diagnosis of cirrhosis were recruited consecutively from liver clinics at three tertiary care hospital sites in Alberta. Individuals were excluded if they: were disoriented to person, place, or time orhad overt hepatic encephalopathy; active malignancy or hepatocellular carcinoma outside of the Alberta liver transplant criteria; end-stage renal disease on dialysis; or were on antidepressants. Patient sociodemographic and cirrhosis characteristics were collected. Patients were identified as having anxiety using the Mini Neuropsychiatric Interview (MINI) modules for panic disorder, agoraphobia, social phobia, and generalized anxiety disorder. The HADS was also completed to assess anxiety. The chronic liver disease questionnaire (CLDQ) and EQ-VAS score were used to determine HRQoL and participants were followed up to 6 months to determine whether they had unplanned hospitalizations or deaths during that time. Of the 369 patients, 65 patients were excluded for being on anti-depressants, leaving a total of 304 patients. Of those, 17.1% had anxiety by the MINI. Multivariate analysis revealed active smoking and 3 HADS subcomponents as independent predictors of anxiety (Table 1). Anxious patients had lower HRQoL as assessed by CLDQ (P < 0.001) and EQ-VAS (P < 0.001) and were more frail by the Clinical Frailty score (P = 0.004). Although numerically higher, there were no statistically significant difference between anxious and non-anxious patients for hospitalizations or death within 6 months of testing (P = 0.14). The 8.2% of patients meeting diagnostic criteria for both anxiety and depression had worse CLDQ, EQ-VAS and Clinical Frailty scores than anxious-only or depressed-only patients. Anxiety is common in patients with cirrhosis and not routinely screened for. Anxiety has a significant impact on HRQoL and functional status, most pronounced in those patients with anxiety-depression overlap. Active smoking and three HADS subcomponents were identified as being independent predictors of anxiety. Multidisciplinary approaches targeting psychosocial and lifestyle factors as well as pharmacological therapies should be explored to treat anxiety in patients with cirrhosis. None
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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 | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".