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Record W3163903497 · doi:10.1097/as9.0000000000000023

Racial Disparities in Surgery

2020· article· en· W3163903497 on OpenAlex

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.

affAt least one author lists a Canadian institution in the pinned OpenAlex snapshot.

Bibliographic record

VenueAnnals of Surgery Open · 2020
Typearticle
Languageen
FieldSocial Sciences
TopicDiversity and Career in Medicine
Canadian institutionsSt. Michael's HospitalPrincess Margaret Cancer CentreUniversity of TorontoUniversity Health Network
Fundersnot available
KeywordsMedicineOdds ratioConfidence intervalInternal medicinePulmonary embolismRetrospective cohort studyMortality rateCardiac surgerySurgery

Abstract

fetched live from OpenAlex

Objective: To determine if Black race is associated with worse short-term postoperative morbidity and mortality when compared to White race in a contemporary, cross-specialty-matched cohort. Background: Growing evidence suggests poorer outcomes for Black patients undergoing surgery. Methods: A retrospective analysis was conducted comprising of all patients undergoing surgery in the National Surgical Quality Improvement Program dataset between 2012 and 2018. One-to-one coarsened exact matching was conducted between Black and White patients. Primary outcome was rate of 30-day morbidity and mortality. Results: After 1:1 matching, 615,118 patients were identified. Black race was associated with increased rate of all-cause morbidity (odds ratio [OR] = 1.10, 95% confidence interval [CI] 1.08–1.13, P < 0.001) and mortality (OR = 1.15, 95% CI 1.01–1.31, P = 0.039). Black race was associated with increased risk of re-intubation (OR = 1.33, 95% CI 1.21–1.48, P < 0.001), pulmonary embolism (OR = 1.55, 95% CI 1.40–1.71, P < 0.001), failure to wean from ventilator for >48 hours (OR = 1.14, 95% CI 1.02–1.29, P < 0.001), progressive renal insufficiency (OR = 1.63, 95% CI 1.43–1.86, P < 0.001), acute renal failure (OR = 1.39, 95% CI 1.16–1.66, P < 0.001), cardiac arrest (OR = 1.47, 95% CI 1.24–1.76 P < 0.001), bleeding requiring transfusion (OR = 1.39, 95% CI 1.34–1.43, P < 0.001), DVT/thrombophlebitis (OR = 1.24, 95% CI 1.14–1.35, P < 0.001), and sepsis/septic shock (OR = 1.09, 95% CI 1.03–1.15, P < 0.001). Black patients were also more likely to have a readmission (OR = 1.12, 95% CI 1.10–1.16, P < 0.001), discharge to a rehabilitation center (OR = 1.73, 95% CI 1.66–1.80, P < 0.001) or facility other than home (OR = 1.20, 95% CI 1.16–1.23, P < 0.001). Conclusion and Relevance: This contemporary matched analysis demonstrates an association with increased morbidity, mortality, and readmissions for Black patients across surgical procedures and specialties.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.277
Threshold uncertainty score0.997

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.498
GPT teacher head0.417
Teacher spread0.081 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it