Healthcare resource utilisation in patients with exacerbations of COPD and associated cardiovascular events: the EXACOS-CV study
Bibliographic record
Abstract
Introduction The EXACOS-CV Canada study described and evaluated treatment patterns, healthcare resource utilisation (HCRU), and costs in patients with COPD who experienced a severe cardiovascular (CV) event or death preceded or not preceded by an exacerbation. Methods This longitudinal, retrospective cohort study included 142 787 individuals with COPD using administrative data from Alberta, Canada. The index event was a first hospitalisation for a CV event or all-cause death during follow-up. COPD-related treatment, HCRU and costs during the 12-month periods before and after the index events were described. Results From the initial cohort, 43 564 (30.5%) patients with COPD experienced an index event; 15 100 (34.7%) had a COPD exacerbation in the 12 months prior. Patients whose index event was preceded ( versus not preceded) by an exacerbation were dispensed higher amounts of COPD therapies in the 12 months prior (proportion of dual therapy: 36.9% versus 24.3%; proportion of triple therapy: 54.6% versus 16.3%) and 12 months following the CV event (proportion of dual therapy: 31.7% versus 27.4%; proportion of triple therapy: 53.4% versus 21.1%). Those with a preceding exacerbation also experienced higher rates of hospitalisations, emergency department admissions and general practitioner and specialist physician visits in both the 12 months prior to and following the index event. Discussion Patients whose index events were preceded versus not preceded by an exacerbation received more treatment regimens and classes of COPD therapy but still incurred more HCRU. Despite the greater healthcare contacts, there remained large treatment gaps in this high-risk population.
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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 | 0.004 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| 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".