A-021 Comparing the Time Between the 1st and 2nd Troponin in Male and Female Patients in Singapore and Calgary, Alberta: Evidence of Extended Pre-preanalytical Time in Females with Low ACS Risk
Bibliographic record
Abstract
Abstract Background At the 2022 AACC national meeting, in our assessment of reference change values (RCV) in troponins ordered in Calgary and Singapore, we postulated that there were gender differences in troponin-ordering between the two cities. Methods Singapore Changi Hospital ED patients [July 2018–July 2020] and Calgary patients [December 2017–December 2021] had hsTnT measured with the Roche Elecsys assay on multiple, local Cobas e801’s. The first two troponins of each patient were selected if they were ordered within 12 h. The troponin pairs were grouped by city, patient sex and whether the troponin pairs fulfilled the criteria of low likelihood of Acute Coronary Syndrome (ACS) according to city specific guidelines. Results The figure compares the average time difference between the first and second troponin test of females and males stratified by the initial troponin value. The paired t-test conducted shows that in Singapore there was no significant difference in the time for females and males to receive a second troponin test while in Calgary the time for females to receive a second troponin test was significantly longer (P < 0.0001) than males. Conclusion The significant difference between Calgary females and males in average time between the first and second troponin tests supports the idea that there may be gender specific differences in troponin ordering timing and patterns. 62%–68% of all laboratory errors originate from pre-pre-analytical processes of which timing is a factor. The well documented atypical presentation of myocardial infarction in females may contribute to the delayed second test in women. This timing difference may be a contributor to the RCV variance observed in our previous study which identified gender differences in the assessment of RCV in troponins ordered in Calgary and Singapore.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot 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.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".