Abstract P113: Variations In 24 Hour Ambulatory Blood Pressure Coverage Across Canada And The United States
Bibliographic record
Abstract
Introduction: The gold standard for diagnosis hypertension is a 24-hour ambulatory blood pressure monitor (ABPM). In-office blood pressure may be falsely high in 30% of individuals (white coat hypertension) or falsely normal in 20% of individuals (masked hypertension). We hypothesize that ABPM funding varies across Canada and the U.S, and sought to investigate this hypothesis. Methods: We reviewed the fee schedules in 14 jurisdictions: 10 Canadian Provinces, three Canadian Territories, and the U.S. Centre for Medicare and Medicaid Services - CMS. We collected data on a) if ABPM is funded, b) indications approved for funding, and c) the reimbursement amount. We summarized this data descriptively. Results: Five jurisdictions (Alberta, Saskatchewan, Quebec, New Brunswick, the U.S. CMS) cover ABPM. The U.S CMS has specific indications for use and limits frequency to one annually, while Saskatchewan limits it to five annually (Table 1). Reimbursement amounts vary widely, from $14.70 to $81.16 (CAD), as do reimbursement components. Prior research using IBM’s MarketScan commercial claims database identified a median ABPM reimbursement by U.S private insurers of $89 (USD). Conclusion: ABPM coverage across Canada and the U.S. fluctuates. There is also variation in reimbursement amount and indications among jurisdictions providing coverage. Further studies should seek to measure if this variation corresponds with a variation in ABPM use, diagnostic rates of masked and white coat hypertension, or antihypertensive spending per capita. We would advocate for jurisdictions that do not currently fund ABPM to consider coverage in light of this geographic variability.
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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 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.004 | 0.012 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 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".