Evidence map›Paper›PMID 38774380›Full record

ArticleEuropean heart journal. Digital health2024

Real-world evaluation of an algorithmic machine-learning-guided testing approach in stable chest pain: a multinational, multicohort study.

Evangelos K Oikonomou, Arya Aminorroaya, Lovedeep S Dhingra, Caitlin Partridge, Eric J Velazquez, Nihar R Desai, Harlan M Krumholz, Edward J Miller, Rohan Khera

Abstract read
In one paragraph

Article in European heart journal. Digital health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

8 citing papers in PubMed.

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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

9 authors.

Evangelos K OikonomouSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.ORCID https://orcid.org/0000-0003-4362-0720
Arya AminorroayaSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.
Lovedeep S DhingraSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.
Caitlin PartridgeYale Center for Clinical Investigation, 2 Church Street South, New Haven, 06519 CT, USA.
Eric J VelazquezSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.ORCID https://orcid.org/0000-0003-2245-7477
Nihar R DesaiSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.
Harlan M KrumholzSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.
Edward J MillerSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.ORCID https://orcid.org/0000-0002-2156-5962
Rohan KheraSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, PO Box 208017, New Haven, 06520-8017 CT, USA.ORCID https://orcid.org/0000-0001-9467-6199

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
Evaluating and Improving Utilization of Evidence-Based Medical Therapy in Patients with Heart Failure using Automated Tools in the Electronic Health RecordK23HL153775 · NHLBI · YALE UNIVERSITY · PI KHERA, ROHAN · 2021 to 2025
$918k
A multi-modal approach for efficient, point-of-care screening of hypertrophic cardiomyopathyF32HL170592 · NHLBI · YALE UNIVERSITY · PI OIKONOMOU, EVANGELOS · 2023 to 2024
$166k
NCATS NIH HHS UL1 TR001863NHLBI NIH HHS F32 HL170592NHLBI NIH HHS K23 HL153775
6 · The paper itself

Abstract

Aims: An algorithmic strategy for anatomical vs. functional testing in suspected coronary artery disease (CAD) (Anatomical vs. Stress teSting decIsion Support Tool; ASSIST) is associated with better outcomes than random selection. However, in the real world, this decision is rarely random. We explored the agreement between a provider-driven vs. simulated algorithmic approach to cardiac testing and its association with outcomes across multinational cohorts. Methods and results: In two cohorts of functional vs. anatomical testing in a US hospital health system [Yale; 2013-2023; Conclusion: In cohorts where historical practices largely favour functional testing, alignment with an algorithmic approach to cardiac testing defined by ASSIST was associated with a lower risk of adverse outcomes. This highlights the potential utility of a data-driven approach in the diagnostic management of CAD.

Indexed as

Artificial intelligenceChest painClinical decision supportMachine learning

Identifiers

PMID38774380
PMCPMC11104476

What OpenQuestion holds

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Registered trials

None linked

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.