Evidence map›Paper›PMID 41507236›Full record

ArticleScientific reports2026

Selective classification with machine learning uncertainty estimates improves ACS prediction: a retrospective study in the prehospital setting.

Juan Jose Garcia, Rebecca Kitzmiller, Ashok Krishnamurthy, Jessica K Zègre-Hemsey

Abstract read
In one paragraph

Article in Scientific reports, 2026. 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
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Juan Jose GarciaDepartment of Computer Science, University of North Carolina at Chapel Hill, Chapel Hill, 27514, USA. jjgarcia@cs.unc.edu.
Rebecca KitzmillerSchool of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, 27514, USA.
Ashok KrishnamurthyRenaissance Computing Institute, Chapel Hill, 27517, USA.
Jessica K Zègre-HemseySchool of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, 27514, USA.

Funding

North Carolina Translational and Clinical Science Institute (NC TraCS) KL2KL2TR002490 · NCATS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI WEINBERGER, MORRIS · 2018 to 2022
$11.0M
Patient-reported Symptoms of Acute Coronary Syndrome in Prehospital Cardiac CareK23NR017896 · NINR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ZEGRE-HEMSEY, JESSICA KATHLEEN · 2019 to 2021
$425k
NCATS NIH HHS KL2 TR002490NINR NIH HHS K23 NR017896
6 · The paper itself

Abstract

Accurate identification of acute coronary syndrome (ACS) in the prehospital setting is important for timely treatments that reduce damage to the compromised myocardium. Current machine learning approaches lack sufficient performance to safely rule-in or rule-out ACS. Our goal is to identify a method that bridges this gap. To do so, we retrospectively evaluate two promising approaches, an ensemble of gradient boosted decision trees (GBDT) and selective classification (SC) on consecutive patients transported by ambulance to the ED with chest pain and/or anginal equivalents. On the task of ACS classification with 23 prehospital covariates, we found the fusion of the two (GBDT+SC) improves the best reported sensitivity and specificity by 8% and 23% respectively. Accordingly, GBDT+SC is safer than current machine learning approaches to rule-in and rule-out of ACS in the prehospital setting.

Indexed as

Acute Coronary SyndromeEmergency Medical ServicesMachine LearningBoosting Machine Learning AlgorithmsClassification AlgorithmsDecision TreesHumansPrediction AlgorithmsPredictive Learning ModelsRetrospective StudiesUncertainty

Identifiers

PMID41507236
PMCPMC12783778

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.