Abstract 222: Does Gender Matter for Postarrest Care?
Bibliographic record
Abstract
Introduction: Studies have shown that after cardiac arrest women have lower survival to discharge rates than men. These differences are surprising, considering that women are more often successfully resuscitated in the prehospital setting. Differences in survival to discharge rates might be partially attributed to disparity in post arrest care, similar to what is seen in myocardial infarction (MI). Hypothesis: There is gender disparity in the provision of targeted post arrest care interventions. Methods: This prospective study explores gender disparity in a prospective Canadian data set of non-traumatic, EMS treated, out of hospital cardiac arrest (OHCA) patients presenting to hospitals in the Strategies for Post Arrest Care (SPARC) network between March 16, 2010 and March 31, 2012. All patients with sustained return of spontaneous circulation (palpable pulse for >20 mins) were included in the analysis. Unadjusted chi square tests and logistic regression models were employed to examine the relationship between gender, and provision of post arrest care interventions (coronary angiography, percutaneous coronary intervention (PCI), therapeutic hypothermia, electrical physiology consultation and internal cardiac defibrillator (ICD) placement and two or more neuroprognostic testing ≥ 72 hours). Results: From a total of 2,199 OHCA patients (1,447 men, 752 women), 992 had sustained return of spontaneous circulation (36.6% women, mean age 68.2 years; 63.4% men, mean age 63.9). There were gender differences in utilization of coronary angiography (12.1% in women vs. 20.8% in men, adjusted OR 0.53, 95% CI 0.36 to 0.77, p=0.013) and PCI (3.7% in women vs. 5.8% in men, adjusted OR 0.63, 95% CI 0.41 to 0.98, p=0.042). ICD was less utilized in women, but differences were not significantly different (4.9% in women vs. 8.1% in men, adjusted OR 0.59, 95% CI 0.33 to 1.02 p=0.062). There were no gender differences in utilization of therapeutic hypothermia and neuroprognostic testing ≥ 72 hours. Conclusion: The observed gender differences in utilization of coronary angiography and PCI intervention may be due to disparity in care and/or differences in underlying pathophysiology of cardiac arrest between men and women contributing to women’s unfavorable outcomes.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
| gpt | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Observational | low |
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 | 0.001 | 0.006 |
| 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 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 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, unvalidatedLabeled directly by 2 models reading the full record.
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".