Taking risk to heart: An evaluation of cardiometabolic risk and screening guideline adherence in outpatients with spinal cord injury
Bibliographic record
Abstract
OBJECTIVES: To evaluate cardiometabolic disease (CMD) in outpatients with spinal cord injury/disease (SCI/D). The study aims were to (1) estimate the prevalence of CMD risk factors in a cohort of Canadian adults with SCI/D; (2) assess whether the frequency of CMD screening aligns with evidence-based guidelines; and (3) gain a preliminary understanding of the barriers to CMD screening and/or treatment within a rehabilitation program setting. DESIGN: Quality improvement initiative involving chart review extracting the presence of and frequency of screening for four CMD risk factors (obesity, hypertension, dyslipidemia, diabetes mellitus). Values were compared to evidence-based guidelines for CMD risk identification and management. Root cause analysis and focused interviews were conducted with clinic staff to identify barriers. SETTING: Academic, tertiary rehabilitation hospital. PARTICIPANTS: = 73). RESULTS: 43.8% of outpatients sampled had established CMD (≥3 risk factors) and 94.5% had at least one risk factor. Obesity was the most prevalent (82.2%), followed by dyslipidemia (71.7%), hypertension (46.5%), and diabetes mellitus (34.8%). Hypertension and obesity screening were completed at 14.3% and 10.4% of appointments. The frequency of dyslipidemia and diabetes mellitus screening could not be determined. Eighteen barriers to timely CMD screening and treatment intensification were identified. CONCLUSIONS: The prevalence of CMD risk factors in outpatients with SCI/D was high. While approximately two of every five outpatients had established CMD, adherence to screening guidelines was poor. These findings reinforce the need for strategies to improve screening and reduce preventable harm from CMD in this vulnerable population.
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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 | 0.004 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".