Endovascular Therapy and Ethnic Disparities in Stroke Outcomes
Why this work is in the frame
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Bibliographic record
Abstract
<b><i>Background and Purpose:</i></b> Ethnic disparities in stroke are well described, with a higher incidence of disability and increased mortality in Blacks versus Whites. We sought to compare the clinical outcomes between those ethnic groups after stroke endovascular therapy (ET). <b><i>Methods:</i></b> We performed a retrospective review of the prospectively acquired Grady Endovascular Stroke Outcomes Registry between September 1, 2010 and September 30, 2015. Patients were dichotomized into two groups – Caucasians and African-Americans – and matched for age, pretreatment glucose level, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Baseline characteristics as well as procedural and outcome parameters were compared. <b><i>Results:</i></b> Out of the 830 patients treated with ET, 308 pairs of patients (<i>n</i> = 616) underwent primary analysis. African-Americans were younger (<i>p</i> &#x3c; 0.01), had a higher prevalence of hypertension (<i>p</i> &#x3c; 0.01) and diabetes (<i>p</i> = 0.04), and had higher Alberta Stroke Program Early CT Score values (<i>p</i> = 0.03) and shorter times to treatment (<i>p</i> = 0.01). Blacks more frequently had Medicaid coverage and less private insurance (29.6 vs. 11.4% and 41.5 vs. 60.3%, respectively, <i>p</i> &#x3c; 0.01). The remaining baseline characteristics, including baseline NIHSS score and CT perfusion-derived ischemic core volumes, were well balanced. There were no differences in the overall distribution of 90-day modified Rankin scale scores (<i>p</i> = 0.28), rates of successful reperfusion (84.7 vs. 85.7%, <i>p</i> = 0.91), good outcomes (49.1 vs. 44%, <i>p</i> = 0.24), or parenchymal hematomas (6.5 vs. 6.8%, <i>p</i> = 1.00). Blacks had lower 90-day mortality rates (18 vs. 24.6%, <i>p</i> = 0.04) in univariate analysis, which persisted as a nonsignificant trend after adjustment for potential confounders (OR 0.52, 95% CI 0.26–1.03, <i>p</i> = 0.06). <b><i>Conclusions:</i></b> Despite unique baseline characteristics, African-Americans treated with ET for large vessel occlusion strokes have similar outcomes as Caucasians. Greater availability of ET may diminish the ethnic/racial disparities in stroke outcomes.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 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 it