ArticleBritish journal of clinical pharmacology2018
A smart algorithm for the prevention and risk management of QTc prolongation based on the optimized RISQ-PATH model.
Article in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Electrocardiographic identification of drug effects: QT prolongation, arrhythmias, and clinical monitoring.European journal of clinical pharmacology · 2026Pooled it
- Risk assessment tools for QT prolonging pharmacotherapy in older adults: a systematic review.European journal of clinical pharmacology · 2022Pooled it
- Risk for QTc prolongation in patients of various medical specialties - a retrospective study on risk factors and usability of the Tisdale Score.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- QT Prolongation and Arrhythmias in Cancer Therapy: A Narrative Review of Mechanistic and Clinical Studies.Cardiovascular toxicology · 2026Review
- Clinical impact of a multidisciplinary remote-based hybrid antibiotic stewardship program in critically ill patients during COVID-19 pandemic in Korea: a prospective pilot implementation study.Antimicrobial resistance and infection control · 2026Article
- Tisdale-score-based risk stratification of QTc prolongations in hospitalized patients receiving azole antifungal therapy-a retrospective study.Frontiers in cardiovascular medicine · 2026Article
- Risk prediction of QTc prolongation occurrence in cancer patients treated with commonly used oral tyrosine kinase inhibitors: machine learning modeling or conventional statistical analysis better?BMC medical informatics and decision making · 2025Article
- Risk Stratification of QTc Prolongations in Hospitalized Cardiology and Gastroenterology Patients Using the Tisdale Score-A Retrospective Analysis.Journal of clinical medicine · 2025Article
- Determining sensitivity and specificity of risk scores for QTc interval prolongation in hemato-oncology patients prescribed systemic antifungal therapy: a retrospective cross-sectional study.International journal of clinical pharmacy · 2024Article
- A Calculated Risk: Evaluation of QTc Drug-Drug Interaction (DDI) Clinical Decision Support (CDS) Alerts and Performance of the Tisdale Risk Score Calculator.Drug safety · 2024Article
- The Impact of Customized Screening Intervals on the Burden of Drug-Drug Interaction Alerts: An Interrupted Time Series Analysis.Journal of medical systems · 2024Article
- A QTc risk score in patients with obstructive sleep apnea.Sleep medicine · 2023Article
- Interpretable Machine Learning Prediction of Drug-Induced QT Prolongation: Electronic Health Record Analysis.Journal of medical Internet research · 2022Article
- Prolonged QT Interval in Cirrhosis: Twisting Time?Gut and liver · 2022Review
- Conundrum of Clinical QTc Monitoring.Drug safety · 2022Article
- Cost-effectiveness of check of medication appropriateness: methodological approach.International journal of clinical pharmacy · 2022Article
- Overall performance of a drug-drug interaction clinical decision support system: quantitative evaluation and end-user survey.BMC medical informatics and decision making · 2022Article
- A smart algorithm for the prevention and risk management of QTc prolongation based on the optimized RISQ-PATH model.British journal of clinical pharmacology · 2018Article
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6 authors.
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Abstract
aimsQTc prolongation is a complex problem linked with multiple risk factors. The RISQ-PATH score was previously developed to identify high-risk patients for QTc prolongation. The aim of this study was to optimize and validate this risk score in a large patient cohort, and to propose an algorithm to generate smart QT signals in the electronic medical record.
methodsA retrospective study was performed in the Nexus hospital network (n = 17) in Belgium. All electrocardiograms performed in 2015 in both ambulatory and hospitalized patients were collected together with risk factors for QTc prolongation (training database). Multiple logistic regression was performed to obtain the optimal prediction (RISQ-PATH) model. The model was tested in a validation database (electrocardiograms between January and April 2016).
resultsIn total, 60 208 patients (52.8% males, mean age 63 ± 18 years) were included; 3543 patients (5.9%) had a QTc ≥ 450(♂)/470(♀) ms and 453 (0.8%) a QTc ≥ 500 ms. The optimized RISQ-PATH model has an area under the ROC-curve of 0.772 [95% CI 0.763-0.780] to predict QTc ≥ 450(♂)/470(♀)ms. A predicted probability of ≥0.035 was set as cutoff for a high risk of QTc prolongation. This cutoff resulted in a sensitivity of 87.4% [95% CI 86.2-88.5] and a specificity of 46.2% [95% CI 45.8-46.6]. These results could be confirmed for QTc ≥ 500 ms and in the validation database (n = 28 400).
conclusionsThe RISQ-PATH model, with a cutoff probability of 0.035, predicted a prolonged QTc interval ≥ 450/470 ms or ≥500 ms with a sensitivity of ±87% and a specificity of ±45%. This RISQ-PATH model can be used in clinical decision support systems to create smart QT alerts.
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