Evidence map›Paper›PMID 40814213›Full record

ArticleESC heart failure2025

Facilitators, barriers, and insights using an HFA-PEFF-based clinical decision support system: A proof-of-concept study.

Isidora Milosavljević, Ivan Petrović, Aleksandra Ilić, Dragana Dabović, Aleksandra Milovančev, Goran Remer, Vladimir Vuković, Dimitrije Zdravković, Maja Stefanović, Snežana Stojšić and 20 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESC heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

30 authors.

Isidora MilosavljevićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.ORCID https://orcid.org/0009-0007-6743-2691
Ivan PetrovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Aleksandra IlićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Dragana DabovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Aleksandra MilovančevFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Goran RemerInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Vladimir VukovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Dimitrije ZdravkovićFaculty of Medicine, University of Belgrade, Belgrade, Serbia.
Maja StefanovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Snežana StojšićInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Ana BalenovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Goran LončarFaculty of Medicine, University of Belgrade, Belgrade, Serbia.
Snežana TadićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Milana JarakovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Snežana BjelićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Snežana ČemerlićInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Marija BjelobrkFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Tatjana MiljkovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Andrej PrevedenFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Milovan PetrovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Srdjan MaletinFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Tanja PopovInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Vanja Drljević TodićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Mirko TodićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Aleksandra VulinFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Milenko ČankovićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Dragica AndrićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Dragoslava Živkov ŠaponjaInstitute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Aleksandar RedžekFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Anastazija Stojšić MilosavljevićFaculty of Medicine, University of Novi Sad, Novi Sad, Serbia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsKnowing that heart failure (HF) with preserved ejection fraction (HFpEF) can be difficult to diagnose, a clinical decision support system (CDSS), with functional, morphological and biomarker domains, was built. Therefore, this research aimed to analyse the possibility of implementing CDSS, compliance of the physicians with the CDSS recommendations, as well as identify obstacles and facilitators to its usage.

methodsThis mixed-methods study was conducted over a 1 year period at the Institute of Cardiovascular Diseases of Vojvodina (Sremska Kamenica, Serbia). The retrospective component included an analysis of patients who had symptoms and/or signs of HF, with an ejection fraction (EF) of ≥50%. The Heart Failure Association pre-test assessment, echocardiography and natriuretic peptide, functional testing, final aetiology (HFA-PEFF) score was used to build a CDSS and to calculate the probability scores for these patients. The prospective component involved an electronic survey that was used to gain feedback from physicians about the CDSS.

resultsThe sample included 225 patients, out of which 194 (86.2%) had the HFA-PEFF score of 5-6, suggesting probable HFpEF. This syndrome was clinically documented in the discharge report in only 32 (16.5%) of these patients. The response rate of the survey was 83.3%, including physicians at different levels of education. Barriers to CDSS usage included a lack of echocardiographic skills and knowledge about phenotype profiling in HFpEF patients. An increase in explainability and transparency, as well as staff education, were mentioned as the main facilitators.

conclusionsThe CDSS demonstrated reasonable effectiveness in diagnosing and classifying patients with symptoms of HF if the measured EF was ≥50%. The conducted survey highlighted that physician education, in both CDSS- and HFpEF-related domains, is a key factor in the battle against HFpEF.

Indexed as

Decision Support Systems, ClinicalHeart FailureStroke VolumeAgedEchocardiographyFemaleFollow-Up StudiesHumansMaleMiddle AgedProof of Concept StudyProspective StudiesRetrospective StudiesSerbiaclinical decision support systemheart failureHFpEF

Identifiers

PMID40814213
PMCPMC12450785

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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.