P312 Evaluation of an antiretroviral therapy (ART) interruption alert and referral system in british columbia (BC), canada
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
<h3>Background</h3> In mid-2016, the BC HIV Drug Treatment Program (DTP) expanded its province-wide prescriber alert system for ART interruptions to include direct referrals to public health offices for persons off treatment for >4 months. We examined outcomes before and after launch of this Re-Engagement and Engagement in Treatment for Antiretroviral Interrupted and Naïve populations (RETAIN) Initiative. <h3>Methods</h3> We analyzed adult, DTP participants with ART interruptions triggering a physician-directed alert (ART refill >2 months late) in pre-RETAIN (Jul-2013 to Apr-2016) and post-RETAIN (May-2016 to Oct-2017) periods, based on the first alert issued within the study period. Follow-up continued until Oct-2018, excluding persons who moved or died within 90 days of an alert being sent. We compared the proportion of persons who were linked to care, re-started ART, or achieved viral suppression in the pre- and post-RETAIN periods, and the time to ART re-initiation using a generalized estimating equation model. <h3>Results</h3> There were 3219 alerts sent for 1805 patients, 1374 related to first interruptions in the pre-RETAIN period and 431 post-RETAIN. Of these, 135/431 (31%) post-RETAIN cases were referred to public health within 4 months following the first alert. Patients were predominantly male (74%) with a median age of 47 years. We found no statistically significant differences in the proportions of persons who were linked to care (83% vs 83%), re-started ART within 4 months (73% vs 74%), or achieved viral suppression (61% vs 62%) between the two periods. Among persons who re-initiated ART >4 months following the initial alert, the median (Q1-Q3) time to ART restart declined significantly from 9 (6–15) months pre-RETAIN to 8 (6–11) months post-RETAIN (p=0.004), possibly influenced by public health intervention. <h3>Conclusion</h3> We observed shorter time to re-initiation after the introduction of referrals for public health support. Similar systems could be considered in other jurisdictions. <h3>Disclosure</h3> No significant relationships.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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 it