Predictors and Outcomes Associated with Clinically Significant Improvements in Anxiety and Depression Symptoms Following Cardiac Rehabilitation
Bibliographic record
Abstract
BACKGROUND: Cardiac rehabilitation (CR) participation improves depressive and anxious symptoms post-coronary catheterization, yet it is unclear to what extent improvements are clinically significant. This study characterized the proportion of patients achieving a minimal clinically important difference (MCID) on the Hospital Anxiety and Depression scale (HADS) following CR and evaluated associations between MCID, patient characteristics, and mortality. METHODS: A retrospective analysis of data was conducted at a large Canadian CR centre. Patients were adults (18+) who participated in CR post-coronary catheterization. HADS and risk factor data were assessed at baseline and 12-weeks. MCID was defined as ≥1.7-point decrease in HADS-Depression or HADS-Anxiety. Univariate and multivariable logistic regressions and Cox proportional analyses were performed. RESULTS: Among 2,702 patients (60.2±10.4 years old, 20.0% female), 29.8% and 36.6% achieved MCID in depressive or anxious symptoms, respectively. In subsamples of patients with elevated baseline HADS symptoms [i.e., HADS-Depression (n=339) or HADS-anxiety (n=848); subscale scores ≥8], more than half reached the MCID threshold (60.5% and 57.0%, respectively). Factors associated with depressive symptom improvement included younger age and higher baseline HADS. Younger age, lower BMI, higher total cholesterol, and higher baseline HADS were associated with improved anxious symptoms. Achieving an MCID in depressive or anxious symptoms did not predict improved survival. CONCLUSIONS: More than one-in-two patients with elevated baseline HADS experienced a clinically meaningful improvement in depressive and anxious symptoms. More research is needed to understand the impact of clinically relevant improvement in psychological symptoms on survival post-coronary catheterization.
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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 | 0.003 |
| 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 | 0.001 | 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".