Evidence map›Paper›PMID 24400205›Full record

ArticleCardiovascular diagnosis and therapy2013

Improved diagnosis and prognosis using Decisions Informed by Combining Entities (DICE): results from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE).

Mark Doyle, Gerald M Pohost, C Noel Bairey Merz, Leslee J Shaw, George Sopko, William J Rogers, Barry L Sharaf, Carl J Pepine, Diane A Vido-Thompson, Geetha Rayarao and 4 more

Abstract read
In one paragraph

Article in Cardiovascular diagnosis and therapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Article
  3. The potential value of discordant studies.Cardiovascular diagnosis and therapy · 2014
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 1 country.

Mark DoyleAllegheny General Hospital, Pittsburgh, PA, USA;
Gerald M PohostKeck Medical Center, University of Southern California, Los Angeles, CA, USA;
C Noel Bairey MerzDivision of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;
Leslee J ShawDivision of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA;
George SopkoNational Heart Lung and Blood Institute, NIH, USA;
William J RogersThe University of Alabama at Birmingham, AL, USA;
Barry L SharafBrown University, Providence, RI, USA;
Carl J PepineUniversity of Florida, Gainesville, FL, USA;
Diane A Vido-ThompsonAllegheny General Hospital, Pittsburgh, PA, USA;
Geetha RayaraoAllegheny General Hospital, Pittsburgh, PA, USA;
Lindsey TauxeThe University of Alabama at Birmingham, AL, USA;
Sheryl F KelseyGraduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA;
Douglas Mc NairCerner Math, Kansas City, MO, USA.
Robert W BiedermanAllegheny General Hospital, Pittsburgh, PA, USA;
Allegheny General Hospital · USCedars-Sinai Medical Center · USUniversity of Alabama at Birmingham · USBrown University · USCerner (United States) · USNational Heart Lung and Blood Institute · USUniversity of Florida · USUniversity of Pittsburgh · USUniversity of Southern California · US

Funding

Prediction of Cardiomyopathy in Type I Diabetes by MRSR01HL073412 · NHLBI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI POHOST, GERALD MICHAEL · 2002 to 2007
$2.0M
Functional MRI of the pharyngeal airwayR01HL068162 · NHLBI · UNIVERSITY OF ARIZONA · PI FREGOSI, RALPH FRANK · 2003 to 2005
$899k
ISCHEMIC HEART DISEASE IN WOMEN--CLINICAL CENTERN01HV068163 · HV · UNIVERSITY OF FLORIDA · PI PEPINE, CARL J · 1996 to 2001
$386k
ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CENTERN01HV068161 · HV · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI ROGERS, WILLIAM J · 1996 to 2000
$245k
EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTR-N01HV68162-268068162N01HV068162 · HV · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1996 to 2005
–
EVAL OF ISCHEMIC HEART DISEASE IN WOMEN-CLINICAL CTRN01HV068164 · HV · ALLEGHENY-SINGER RESEARCH INSTITUTE · PI REICHEK, NATHANIEL · 1996 to 2001
–
NHLBI NIH HHS N01 HV068161NHLBI NIH HHS N01 HV068162NHLBI NIH HHS N01 HV068163NHLBI NIH HHS N01 HV068164NHLBI NIH HHS R01 HL073412
6 · The paper itself

Abstract

objectivesTo introduce an algorithmic approach to improve the interpretation of myocardial perfusion images in women with suspected myocardial ischemia.

backgroundGated single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) approaches have relatively poor diagnostic and prognostic value in women with suspected myocardial ischemia. Here we introduce an approach: Decisions Informed by Combining Entities (DICE) that forms a mathematical model utilizing MPI and cardiac dimensions generated by one modality to predict the perfusion status of another modality. The effect of the model is to systematically incorporate cardiac metrics that influence the interpretation of perfusion images, leading to greater consistency in designation of myocardial perfusion status between studies.

methodsWomen (n=213), with suspected myocardial ischemia, underwent MPI assessment for regional perfusion defects using two modalities: gated SPECT (n=207) and MR imaging (n=203). To determine perfusion status, MR data were evaluated qualitatively and semi-quantitatively while SPECT data were evaluated using conventional clinical criteria. These perfusion status readings were designated "Original". Four regression models were generated to model perfusion status obtained with one modality [e.g., semi-quantitative magnetic resonance imaging (MRI)] against another modality (e.g., SPECT) and a threshold applied (DICE modeling) to designate perfusion status as normal or low. The DICE models included perfusion status, left ventricular (LV) chamber volumes and myocardial wall thickness. Women were followed for 40±16 months for the development of first major adverse cardiovascular event (MACE: CV death, nonfatal myocardial infarction (MI) or hospitalization for congestive heart failure). Original and DICE perfusion status were compared in their ability to detect high-grade coronary artery disease (CAD) and for prediction of MACE.

resultsAdverse events occurred in 25 (12%) women and CAD was present in 34 (16%). In receiver-operator characteristic (ROC) analysis for CAD detection, the average area under the curve (AUC) for DICE vs. Original status was 0.77±0.03 vs. 0.70±0.03, P<0.01. Similarly, in Kaplan-Meier survival analysis the average log-rank statistic was higher for DICE vs. the Original readings (10.6±5.2 vs. 3.0±0.6, P<0.05).

conclusionsWhile two data sets are required to generate the DICE models no knowledge of follow-up results is needed. DICE modeling improved diagnostic and prognostic value vs. the Original interpretation of the myocardial perfusion status.

Indexed as

diagnosisimagingModelingperfusionprognosiswomen

Identifiers

PMID24400205
PMCPMC3878119
OpenAlexW2231222092

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.