Cardiomyopathy Screening Adherence Among Medicaid‐Enrolled Long‐Term Survivors of Childhood Cancer
Bibliographic record
Abstract
BACKGROUND: Childhood cancer survivors face increased risks of adverse cardiovascular outcomes due to treatment exposures. National guidelines recommend periodic cardiomyopathy screening for survivors exposed to anthracyclines or radiation. We examined the receipt of and the adherence to guideline-recommended cardiomyopathy testing (echocardiogram, multigated acquisition scan, magnetic resonance imaging) among Medicaid-enrolled childhood cancer survivors. METHOD: Using data from the Childhood Cancer Survivor Study linked to administrative Medicaid claims, we analyzed 1062 at-risk survivors aged 18-64 years who were continuously enrolled in Medicaid each year throughout 2015-2019. RESULTS: We found that 26.8% received any cardiomyopathy test, and 9.6% adhered to guidelines. Residence in Medicaid expansion (vs. non-expansion) states was associated with 6.9% points (95% CI = 0.7-13.1) higher likelihood of receiving any cardiomyopathy test and 4.2% points (95% CI = 0.4-7.9) higher likelihood of adherence. CONCLUSIONS: These findings suggest low receipt and poor adherence to guideline-recommended cardiomyopathy screening among long-term survivors of childhood cancer. Our data further underscore the critical role of Medicaid programs in supporting access to quality survivorship care for 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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 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".