Abstract 9541: Comparing Patient Reported Outcomes and New York Heart Association Class Among Patients Hospitalized for Heart Failure
Bibliographic record
Abstract
Background: The New York Heart Association (NYHA) classification remains a cornerstone nomenclature for quantifying health status of patients with heart failure (HF). How this clinician-reported classification compares with patient-reported outcomes among patients hospitalized for HF is unclear. Methods: ASCEND-HF was a global randomized trial comparing nesiritide versus placebo among patients hospitalized for HF, irrespective of EF. Among patients with complete baseline data for NYHA class and the patient-reported EuroQOL-5 dimensions (EQ-5D), each scale was organized into 4 levels (NYHA Class I-IV; EQ-5D utility index [UI] 0.75-1.00, 0.50-0.74, 0.25-0.49, <0.25 and EQ-5D visual analogue scale [VAS] 75-100, 50-74, 25-49, <25). Levels of NYHA class and EQ-5D were then mapped to each other from “best” to “worst.” Minor and moderate-severe discordance were defined as NYHA class and EQ-5D differing by 1 level and ≥2 levels, respectively. Factors associated with moderate-severe discordance were then assessed via backwards selection multivariable regression. Results: Among 5,741 patients, concordance, minor and moderate-severe discordance between NYHA class and EQ-5D UI occurred in 22%, 40% and 38% of patients, respectively. For EQ-5D VAS, this categorization occurred in 29%, 48% and 23%. Discordance was more often due to worse NYHA class. Patients with moderate-severe discordance were more likely to have worse NYHA class and higher EQ-5D scores. NYHA Class IV, higher EQ-5D scores, race and geographic region were among multiple patient factors independently associated with moderate-severe discordance (Figure 1). Conclusions: In patients hospitalized for HF, the majority exhibited discordance between the clinician-reported NYHA class and patient-reported health status. Discordance was more often due to worse NYHA class. Multiple patient factors were independently associated with higher likelihood of moderate-severe discordance.
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How this classification was reachedexpand
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) | 0.000 | 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 teacher head, 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".