Abstract WP376: Home-Time as a Surrogate Marker of Global Disability After Ischemic and Hemorrhagic Strokes in Canada
Bibliographic record
Abstract
Objective: The 90-day home-time (90HT) indicator is a patient-centered outcome metric that is correlated with global disability after ischemic stroke (IS), but has not been well-characterized after intracerebral hemorrhage (ICH). 90HT is defined as the total number of days a patient is living outside of a healthcare institution in the first 90 days after stroke. We determined the association between 90HT and discharge modified Rankin Scale (mRS) after IS or ICH in the population of Ontario, Canada. Methods: All admissions for stroke in the Ontario Stroke Registry between 2003 and 2013 were included and 90HT was calculated using linked administrative data. We used Spearman’s rank correlation to quantify the correlation between 90HT and discharge mRS. We used multivariable logistic regression analysis with adjustment for age, sex, stroke severity, Charlson comorbidity index, pre-admission dependence, rural residency, and socioeconomic status to determine the association between 90HT and poor outcome (mRS>2). Results: We identified 40,242 unique admissions (84% IS, 16% ICH, median age was 74 years (IQR 63-82), and 53% were male). The median 90HT (IQR) was 55 days (0-82) for IS and 0 days (0-58) for ICH. Longer 90HT was correlated with lower mRS for both stroke types (IS r= -0.78; ICH r= -0.80). Figure 1 shows the distribution of 90HT by mRS by stroke type. In multivariable analysis, longer 90HT was associated with lower likelihood of poor outcome (Odds Ratio 0.76 95%CI [0.75-0.76] per 5 additional days at home) and stroke type did not modify this association. Conclusions: The correlation between 90HT and mRS categories was maintained regardless of stroke type, suggesting that longer 90HT derived from administrative data is a robust surrogate for lower global disability after IS or ICH. Further, 90HT is a sensitive metric, as we showed that patients with ICH experience shorter time at home than those with IS, consistent with the observation that the former have higher disability.
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.006 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".