Epidemiology of Lower Extremity Amputations in the United States: An Analysis of the Global Burden of Disease Database From 1990 to 2019
Bibliographic record
Abstract
BACKGROUND: Lower extremity amputations (LEAs) are medically, psychologically, and functionally devastating. The objective of our study was to evaluate region- and sex-specific differences of unilateral and bilateral LEAs across the United States (US) from 1990 to 2019. METHODS: The Global Burden of Disease database was used to analyze years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people for LEAs in the US from 1990 to 2019. Data were stratified into four US Census Bureau-defined regions: Northeast, Midwest, South, and West. Differences between regions and sexes were assessed, with statistical significance defined as p < 0.05. RESULTS: From 1990 to 2019, the US experienced an overall decrease in YLDs (33.07%), incidence (22.11%), and prevalence (29.93%) of bilateral LEAs. Unilateral LEAs saw a decrease in YLDs (21.43%) and prevalence (15.61%), but an increase in incidence (9.05%). Men surpassed women in YLDs, incidence, and prevalence of unilateral and bilateral LEAs in all regions. The West had the highest incidence and prevalence of both bilateral and unilateral LEAs from 1990 to 2019. By 2019, the South had the lowest incidence, and the Northeast had the lowest YLDs and prevalence of bilateral and unilateral LEAs. CONCLUSIONS: From 1990 to 2019, the US experienced decreases in YLDs, prevalence, and incidence of unilateral and bilateral LEAs, except for an increased incidence of unilateral LEAs. Men experienced higher rates than women across each region. The West generally had the highest overall rates. These trends highlight sex-specific and regional disparities of LEAs.
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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 | 0.000 | 0.000 |
| 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 | 0.000 |
| 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".