919-P: Identifying Clinical Phenotypes in Patients with Type 2 Diabetes Using Unsupervised Cluster Analysis—Insights from the CANVAS Program and CREDENCE Trial
Bibliographic record
Abstract
Background: Limited understanding exists regarding phenotypic heterogeneity in type 2 diabetes (T2D) patients and its therapeutic impact. Methods: A pooled latent class analysis of the CANVAS Program and CREDENCE trial was conducted to identify T2D clinical phenotypes. The composite outcome of cardiovascular death (CVD) or hospitalization for heart failure (HHF) was analyzed and proportional hazards models assessed the effect of canagliflozin across phenotypes. Results: Four phenotypes were identified: Phenotype 1 (n=966, 6.6%) with the lowest prevalence of heart failure, kidney dysfunction, and hypertension; Phenotype 2 (n=4169, 28.7%), primarily females with high atherosclerotic cardiovascular disease (ASCVD) prevalence; Phenotype 3 (n=7108, 48.9%), predominately men with high ASCVD prevalence; and Phenotype 4 (n=2300, 15.8%) with the highest prevalence of heart failure and renal dysfunction. Differential risk for CVD or HHF across phenotypes was observed, with the lowest risk in Phenotype 1 and the highest risk in Phenotype 4 (HR 5.21 [95% CI: 3.69-7.36]; Fig 1A and B). Canagliflozin significantly reduced CVD or HHF across phenotypes (P-interaction > 0.05). Conclusion: This study identified four distinct T2D phenotypes with differential CV risk. Canagliflozin significantly reduced the risk of CVD or HHF across phenotypes. Disclosure A. Razaghizad: None. J. Ni: None. E. Possik: None. M. Tsoukas: Speaker's Bureau; Novo Nordisk, Eli Lilly and Company, Boehringer-Ingelheim, Janssen Pharmaceuticals, Inc., AstraZeneca, Sanofi, Bausch Health, Abbott. T.A. Mavrakanas: Research Support; AstraZeneca. Other Relationship; AstraZeneca, Janssen Pharmaceuticals, Inc., Pfizer Inc. Advisory Panel; Bayer Inc. Other Relationship; Bayer Inc. Advisory Panel; Servier Laboratories. Other Relationship; Boehringer-Ingelheim. Advisory Panel; Boehringer-Ingelheim, GlaxoSmithKline plc. T. Huynh: Research Support; Pfizer Inc., Merck & Co., Inc., Bayer Inc. Speaker's Bureau; GlaxoSmithKline plc. W. Swardfager: None. P. Marques: Other Relationship; Janssen Pharmaceuticals, Inc. A. Sharma: Other Relationship; Boehringer-Ingelheim. Research Support; Janssen Pharmaceuticals, Inc. Other Relationship; Novo Nordisk. Advisory Panel; Novartis Canada. Other Relationship; AstraZeneca. Advisory Panel; Servier Laboratories, Takeda Pharmaceutical Company Limited. Research Support; Boston Scientific Corporation, Medtronic, Amgen Inc.
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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 | 0.007 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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".