Anticoagulant Use in Older Patients Receiving Home Palliative Care: A Retrospective Cohort Study
Bibliographic record
Abstract
Objective: To describe the prevalence of anticoagulant use and identify predictive factors for anticoagulant discontinuation among home palliative care recipients in Ontario.Methodology: Linked administrative population-based healthcare databases were used to identify and study home palliative care recipients ≥66 years old in Ontario from 2010-2019. The prevalence of anticoagulant use was calculated. Multilevel models were used to study patient and provider factors associated with early anticoagulant discontinuation following initial home palliative care consultation. Results: 98,089 older adults initiated home palliative care from 2010-2018, among whom 15.5% were taking anticoagulants. By multilevel logistic regression, few patient or physician characteristics—and neither comorbidity nor indications for therapeutic anticoagulation—were associated with discontinuation. Mean discontinuation rates by physician quintile ranged from 7-49%. Conclusion: Among home palliative care recipients, anticoagulant use is common and discontinuation may relate largely to physician preference. Further study on the risks and benefits of anticoagulants in this population is warranted.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 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) | 0.001 | 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".