Evaluating the role of primary care physicians in the treatment of latent tuberculosis: a population study
Bibliographic record
Abstract
Background: Tuberculosis (TB) remains within the world's most important infectious causes of morbidity and mortality among adults. There are close to 10 million new cases of TB annually and latent TB (LTBI) is the main source of new active cases. Treatment of LTBI is long and often results in poor treatment completion rates. Primary care physicians have been identified as playing an important role in LTBI treatment; however, how large a role they currently play and the impact of this have not been assessed. Objective: To estimate the treatment completion rate in individuals receiving therapy for LTBI when the treatment is initiated by a primary care physician after controlling for initial health status and other patients characteristics. Study design and population: The province of Quebec (Canada) provides TB treatment free of charge to all residents. The study population consists of all Quebec residents who have been prescribed, for 30 days or more, LTBI therapy between January 1, 1998 and December 31, 2005.Data gathering: Using data from the regional health insurance board (Régie de l'Assurance Maladie du Québec), de-identified data was extracted from the beneficiaries database, the medical services database, the prescription claims database and the hospital services database (Med-Echo), all linked with a unique patient identifier. Basic descriptive statistics were done to describe the study population and determine the proportion of treatment initiated by primary care physicians. Regression modeling was used to determine what factors were significantly associated with completion rates including the type of prescribing physician. Results: Twenty-six percent of all LTBI prescriptions during the study period were initiated by primary care physicians. This proportion decreased from 1998 (28.7%) until 2005 (21.1%). A total of 6 059 (41.1%) individuals completed the treatment. Individuals prescribed by primary care physicians were less likely to complete the LTBI treatment (OR: 0.80, 95% CI: 0.67-0.95). Conclusions: More than half of patients treated for LTBI are still not completing the recommended regimen. Between a third and a quarter are initiated by primary care physicians. The reasons why completion is less likely for those initiated by primary care physicians need to be investigated.
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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 | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 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".