Temporal trends and regional variations in the burden of chronic obstructive pulmonary disease
Bibliographic record
Abstract
RATIONALE Chronic obstructive pulmonary disease (COPD) imposes a significant burden on individuals and communities. However, long-term trends and their variability within jurisdictions have not been well evaluated.OBJECTIVES This study aimed to assess temporal trends and regional variability in the burden of COPD within a well-defined population under a publicly funded healthcare system.METHODS Using administrative health databases, we conducted a retrospective cohort study of people aged ≥35 years diagnosed with COPD across the 16 health regions of British Columbia, Canada (2010-20). The primary outcomes were prevalence, incidence, all-cause hospital admissions, and all-cause mortality, while secondary outcomes were COPD- and cardiovascular disease (CVD)-specific hospitalization and mortality. We used generalized linear models to examine how outcomes changed over time and varied by regions, controlling for sex, age, socioeconomic status, and rural/urban residence.MAIN RESULTS Over the 11-year study period, there were 312 014 individuals diagnosed with COPD (48.1% female, mean baseline age: 68.2). Across the province, standardized prevalence and all-cause mortality remained relatively stable during the study period, whereas incidence and all-cause hospitalizations declined. There was up to a three-fold difference in standardized incidence and prevalence, and up to a two-fold difference in standardized all-cause hospitalization and mortality across 16 regions (p < 0.05). These differences remained significant after controlling for case mix. Among COPD patients, both CVD-specific hospitalization and mortality were higher compared to COPD-specific hospitalization and mortality.CONCLUSIONS Despite being governed by the same universal healthcare system, there were significant differences in the burden of COPD across geographic regions in this Canadian province.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| 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".