Abstract 5: Differences in Stroke Care Among Patients in the REGARDS Study by Admission to a Hospital Participating versus Not Participating in GWTG-Stroke
Bibliographic record
Abstract
Introduction: Get With The Guidelines (GWTG)-Stroke is a stroke-care quality-improvement program implemented in 1,656 of 5,564 (30%) US hospitals; however, the assessment of the effectiveness of GWTG is limited by the lack of data from hospitals not participating in the program. Methods: The REasons for Geographic And Racial Differences in Stroke (REGARDS) is a national population-based longitudinal cohort study of 30,239 black & white participants aged 45+ years. Participants with an incident stroke were hospitalized in their local hospital. The proportion of patients receiving each of 10 quality-care metrics was calculated among the stroke victims admitted to hospitals with and without GWTG-Stroke. Logistic regression was used to adjust for participant and hospital differences of those seen in GWTG/non-GWTG hospitals. Results: Between 2003 and 2015, 207 of the 546 (38%) REGARDS participants suffering an ischemic stroke were treated in a hospital currently participating in the GWTG-Stroke program (the remainder in a non-GWTG hospital). Those hospitalized in a GWTG hospital were of similar age, race, sex, and risk factor profile as those in non-GWTG hospital (data not shown); however, fewer residents of the Stroke Belt were treated in a GWTG hospital (46.9% vs. 60.8%). Among the hospitals where participants were treated, the GWTG hospitals significantly larger (average 425 versus 289 beds) and were more likely to participate in GME resident training (59.9% versus 40.7%). After adjustment for these differences (see table), patients treated in GWTG hospitals were more likely to receive tPA (OR = 3.69), education on stroke risk factors and warning signs (OR = 1.52), swallowing evaluation (OR = 1.26), lipid profile evaluation (OR = 1.17), and evaluation by a neurologist (OR = 1.12). Conclusions: The care of stroke patients admitted to hospitals participating in the GWTG-Stroke were more likely to meet important stroke quality care metrics.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 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".