Do ethnic minorities improve in exercise capacity following cardiac rehabilitation? a secondary analysis
Bibliographic record
Abstract
Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): SOLVE-CHD NHMRC Grant Background/Introduction Ethnic minorities experience higher rates of cardiovascular disease risks due to a combination of risk factors and socio-cultural influences. While comprehensive cardiac rehabilitation (CR) has well-established benefits for reducing mortality, morbidity, and improving physical fitness, little is known about exercise capacity outcomes for ethnic minorities following CR. Purpose This secondary analysis of data from an observational study aimed to evaluate exercise capacity outcomes of ethnic minorities following CR using 6-minute walk test (6MWT) or metabolic equivalent of task (METs) and to compare it to the majority group. Multiple linear regression models were used to determine if ethnic minority status was an independent predictor of change in 6MWT and METs after adjusting for baseline characteristics (age, sex, diagnosis, smoking, referral site, and wait time). Additionally, a binary logistic regression model was created for completers versus non-completers accounting for baseline variables. Results Participants totalled 2335, of which 326 (14%) were ethnic minorities. The mean age of ethnic minorities was 66.46 (SD 12.12) years, with 228 (70%) males. The most common referral diagnosis was myocardial infarction (27%), angina (25%), other – arrhythmias, cardiac devices, valve diseases/procedures (24%), and cardiac surgery (24%). Ethnic minorities had significantly lower 6MWT scores at baseline compared to the majority (379.9 (SD 118) versus 430.7 (SD 103) meters, p<0.001, but METs were comparable (6.69 (SD 2.73) versus 6.46 (SD 2.28) mg/kg/min, p = 0.69. At CR completion, improvements in 6MWT were equivalent for minority (71.03 (SD 58.57)) and majority (71.37 (SD 61.16)) groups (p = 0.96), as well as METs (minority 3.01 (SD 1.66) versus majority 3.13 (SD 1.74) p = 0.77). Minority status was not an independent predictor of change in 6MWT and METs after accounting for age, sex, diagnosis, smoking, referral site, and wait time. However, participants that were minorities were half as likely to complete (OR 0.49 95% CI 0.38, 0.65). Conclusion Ethnic minorities achieve equivalent improvements in exercise capacity to majority participants following CR. These findings add to the effectiveness evidence of CR, at least for exercise capacity, for diverse populations. However, such benefits would only be gained with adequate participation and CR program completion, which remains poor for ethnic minorities. Improving CR program uptake and completion for ethnic minorities with cardiovascular disease should be prioritised.
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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 | 0.009 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.004 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| 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".