Incidence and risk factors of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism: a systematic review and meta-analysis of cohort studies
Bibliographic record
Abstract
BACKGROUND: The incidence and risk factors of chronic thromboembolic pulmonary hypertension (CTEPH) after acute pulmonary embolism (PE) were still controversial. A systematic review and meta-analysis was conducted to assess the incidence and risk factors of CTEPH after acute PE. METHODS: Embase, Medline, China National Knowledge Infrastructure, Wanfang databases, and various reference lists were searched to identify studies published up to May 2018. Only cohort studies that used right heart catheterization for CTEPH diagnosis were included. The study quality was assessed using the Newcastle-Ottawa Scale (NOS). All analyses were conducted with the meta package in R software (3.2.2). RESULTS: Fifteen studies met the inclusion criteria. The overall incidence of CTEPH after acute PE, with a median follow-up from 6 to 94.3 months, was 3.13% (95% CI: 2.11-4.63%). The incidence of studies from China [4.46% (95% CI: 1.68-11.32%)] was slightly higher than from Europe [2.82% (95% CI: 1.82-4.34%)]. However, there was no significant difference between these two groups (P=0.39). Subgroup analyses of confirmed diagnostic method showed that compared studies using right heart catheterization [3.25% (95% CI: 2.12-4.97%)], studies using right heart catheterization combined with bundled tests tended to yield a similar data [2.40% (95% CI: 0.97-5.81%), P=0.54]. Previous/recurrent PE or previous VTE, idiopathic PE and right heart dysfunction were considered as risk factors of CTEPH in patients with a previous PE. CONCLUSIONS: CTEPH is not a rare complication of acute PE. Close follow-up and implementation of a comprehensive screening program are important, especially in patients with independent risk factors.
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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 | 0.015 | 0.034 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.035 |
| Bibliometrics | 0.008 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 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".