Abstract 9164: Who Receives ASA for Primary Prevention in Canada?: Insight From the PRIMARY CARE AUDIT OF GLOBAL RISK MANAGEMENT (PARADIGM) Study
Bibliographic record
Abstract
BACKGROUND: The role of ASA for primary CVD prevention is controversial. We assessed the use of ASA in healthy, middle-aged subjects in the PARADIGM study. METHODS: PARADIGM enrolled 3015 men >40 or women >50 to assess trends in CV risk assessment. Subjects with diabetes, vascular disease, or those receiving lipid lowering drugs were excluded. We report on the 406 subjects (13.5%) who were receiving ASA for primary CVD prevention. RESULTS: Subjects prescribed ASA, compared to those not, were more likely to be older (61.6 vs. 55.5y, p<0.0001), male (p<0.001), white Caucasian (88.9 vs. 66.6%, p<0.0001), past/current smokers (43.8 vs. 33.3%, p=0.0004), hypertensive (60.8 vs. 25.7%, p<0.00001), and to have a CV family history (30.9 vs. 23.3%, p=0.002). SBP, DBP, creatinine, hsCRP, waist circumference (WC) and BMI were discriminators of ASA use (all p<0.0005). LDL-c fasting glucose, IFG, and HbA1c did not differ between those prescribed ASA or not. Mean modified FRS for those prescribed ASA vs. not were 22.3 vs. 13.5% respectively (p<0.00001). Of those prescribed ASA, FRS categories were 18% low, 47.8% intermediate, and 34.2% high. In ASA-treated subjects, rates of smoking, HT, family history and mean BP, BMI and hsCRP were similar between genders. Mean HDL and LDL (both p<0.0001), glucose (p=0.05), and HbA1c (p=0.0001), were higher in women than men. Mean FRS was lower in ASA-treated women (14.4 vs. 27.0%, p<0.00001). FRS categories for ASA-treated women vs men were: low (34.4 vs 8.2%), intermediate (43 vs. 34.5%), and high (22.5 vs. 57.3%, all p<0.00001). CONCLUSIONS: In PARADIGM, 13.5% of men >40 and women >50 received ASA for primary CVD prevention. Smoking, HT, family history, hsCRP and abdominal obesity were discriminators of ASA use, yet lipid and glycemic levels were not. Two thirds of ASA-treated subjects had low/intermediate FRS. The majority of ASA use in women was in those with low or intermediate risk scores.
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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 | 0.002 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".