S2930 Temporal Trends in the Incidence of Cirrhotic Alcohol-Associated Liver Disease in 3 Northern American Countries Over the Past 3 Decades
Bibliographic record
Abstract
Introduction: Liver cirrhosis imposes a significant global health and socioeconomic burden due to the resultant morbidity, diminished quality of life, and mortality. Alcohol-associated liver (ALD) disease is among the leading etiologies of cirrhosis worldwide. Therefore, evaluating the temporal trends in the incidence of cirrhotic ALD is of paramount significance as it enables introduction of health policy measures. Methods: Temporal trends in the age-standardized incidence rate (ASIR) of cirrhotic ALD in the US, Canada, and Mexico for the period 1990-2019 were evaluated by retrieving relevant data from the Global Burden of Disease database. Joinpoint analysis software was utilised to calculate the Annual Percent Change (APC) and the Average Annual Percent Change (AAPC). Gender stratification was performed to evaluate for any gender differences in the incidence. Results: Over the span of 3 decades, an estimated total of 1,077,041 cirrhosis cases attributed to ALD were reported in the US, Canada, and Mexico with a man predominance of 77.6%. The majority of cases were reported in the US (55.2%), followed by Mexico (42.3%) and Canada (2.5%). Overall, a statistically significant decline was noted in the ASIR across the 3 nations with the highest decline observed in Mexico (AAPC -0.996, 95% CI -1.007 to -0.983, P < 0.001) followed by Canada (AAPC -0.535, 95% CI -0.554 to -0.516, P < 0.001). The US witnessed the lowest decline (AAPC -0.426, 95% CI -0.477 to -0.360, P < 0.001). Interestingly, gender stratification revealed variation in the trends between men and women. Men experienced a statistically significant decline in the ASIR across the 3 countries with the highest decline noted in the US (AAPC -0.613, 95% CI -0.674 to -0.550, P < 0.001) followed by Mexico (AAPC -0.601) and Canada (AAPC -0.573). In women, a statistically significant decline was also noted in Canada and Mexico, with the latter experiencing a higher decline (AAPC -2.471, 95% CI -2.522 to -2.419, P < 0.001). However, the US observed a statistically significant slight increase in the ASIR with an AAPC of 0.055 (95% CI 0.013 to 0.095, P = 0.01). Conclusion: During 1990-2019, the US, Mexico, and Canada observed a significant decline in the incidence of cirrhotic alcoholic liver disease. However, women in the US were observed to have a significant slight increase in the incidence, thus mandating prompt recognition and introduction of health policy measures to tackle the associated burden.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".