Abstract 18613: Utilization of High-Potency Statin Therapy Following Hospitalization for CHD Among Medicare Beneficiaries
Bibliographic record
Abstract
Background: Evidence-based guidelines recommend high-potency statins for secondary prevention in high-risk patients including individuals hospitalized for coronary heart disease (CHD) events. In these patients, initiation of this therapy is recommended upon hospital discharge. Aim: Investigate the proportion of Medicare beneficiaries who fill a prescription for a high potency statin following discharge and within 365 days after hospital discharge for an incident CHD event. Methods: This study included Medicare beneficiaries ≥ 65 years with no documented CHD history in the prior year who were hospitalized and filled a statin following an incident CHD event (myocardial infarction or coronary revascularization procedure) in 2007, 2008 or 2009. High-potency statins included atorvastatin 20 mg to 80 mg, rosuvastatin 10 mg to 40 mg and simvastatin 40 to 80 mg daily. Results: Among 9,455 Medicare beneficiaries filling a statin following an incident CHD hospitalization, 33.8% and 40.2% filled prescriptions for high-potency statins within 90 and 365 days, respectively. The proportion filling a prescription for a high-potency statin declined between 2007 and 2009. After multivariable adjustment, more recent calendar time, progressively older age and higher Charlson scores were associated with a lower likelihood of filling a prescription for a high potency statins and Asians were more likely to fill a prescription for a high potency statin (Table). Conclusions: The majority of Medicare beneficiaries who will a statin following hospitalization for CHD do not fill a high potency statin. The under-utilization of high-potency statin therapy represents a major obstacle to lowering the burden of recurrent cardiovascular events.
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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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".