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Record W3201140601 · doi:10.1136/bmjopen-2021-050335

Intensive versus standard blood pressure control in type 2 diabetes: a restricted mean survival time analysis of a randomised controlled trial

2021· article· en· W3201140601 on OpenAlexaboutno aff
Sandra Shi, Natalia Gouskova, Mehdi Najafzadeh, Lee‐Jen Wei, Dae Hyun Kim

Bibliographic record

VenueBMJ Open · 2021
Typearticle
Languageen
FieldMedicine
TopicBlood Pressure and Hypertension Studies
Canadian institutionsnot available
FundersNational Institute on Aging
KeywordsMedicineBlood pressureInternal medicineType 2 diabetesMyocardial infarctionStroke (engine)Diabetes mellitusClinical endpointSubgroup analysisRandomized controlled trialSurgeryConfidence intervalEndocrinology

Abstract

fetched live from OpenAlex

BACKGROUND: Restricted mean survival time analysis offers an intuitive and robust summary of treatment effect compared with HRs. OBJECTIVE: To examine the effect of intensive versus standard blood pressure (BP) control on death or cardiovascular events in type 2 diabetes. DESIGN: Secondary analysis of the Action to Control Cardiovascular Risk in Diabetes Blood Pressure trial. SETTING: 77 sites in the USA and Canada. PARTICIPANTS: 4733 adults with type 2 diabetes at high risk for cardiovascular events. INTERVENTIONS: Systolic BP target <120 mm Hg (n=2371) versus <140 mm Hg (n=2362). MEASUREMENTS: Composite endpoint of death, non-fatal myocardial infarction or non-fatal stroke. RESULTS: The mean event-free survival time over 5 years (1825 days) was similar between intensive and standard BP control (1716 vs 1714 days; mean difference, 1.3 (95% CI -18.1 to 20.7) days). However, intensive BP treatment was more beneficial for those assigned to standard glycaemic control (1725 vs 1697 days; mean difference, 28.1 (95% CI 0.4 to 55.9) days), but not for those assigned to intensive glycaemic control (1706 vs 1731 days; mean difference, -25.2 (95% CI -52.3 to 1.9) days) (p=0.008 for interaction). In subgroup analysis, the mean event-free survival time difference between intensive and standard BP treatment was -76.0 (95% CI -131.8 to -20.3) days for those with cognitive impairment and 21.8 (95% CI -24.0 to 67.5) days for those with normal cognitive function (p=0.008 for interaction). The effect was not different by age, sex and baseline cardiovascular disease status. CONCLUSIONS: Intensive BP treatment may reduce death and cardiovascular events among patients with type 2 diabetes receiving standard glycaemic treatment and without cognitive impairment. TRIAL REGISTRATION NUMBER: NCT00000620; Post-results.

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.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not 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.

metaresearch head score (Codex)0.031
metaresearch head score (Gemma)0.043
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Randomized trial · Consensus signal: Randomized trial
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.031
Threshold uncertainty score0.161

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0310.043
Meta-epidemiology (narrow)0.0020.001
Meta-epidemiology (broad)0.0130.015
Bibliometrics0.0020.002
Science and technology studies0.0010.002
Scholarly communication0.0030.002
Open science0.0010.001
Research integrity0.0030.004
Insufficient payload (model declined to judge)0.0080.000

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 head0.056
GPT teacher head0.353
Teacher spread0.297 · 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

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designRandomized trial
Domainnot available
GenreEmpirical

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".

Quick stats

Citations12
Published2021
Admission routes1
Has abstractyes

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