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Search: onr:"swepub:oai:DiVA.org:uu-520162" > Personalized diagno...

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  • Neumann, Johannes TobiasUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.;Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Australia.,Monash University,German Centre for Cardiovascular Research,University Medical Center Hamburg-Eppendorf (author)

Personalized diagnosis in suspected myocardial infarction

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • Springer,2023
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-520162
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-520162URI
  • https://doi.org/10.1007/s00392-023-02206-3DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:152785650URI
  • https://lup.lub.lu.se/record/43de5e70-bf53-43d9-bc9f-357786f53a11URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: In suspected myocardial infarction (MI), guidelines recommend using high-sensitivity cardiac troponin (hscTn)- based approaches. These require fixed assay-specific thresholds and timepoints, without directly integrating clinical information. Using machine-learning techniques including hs-cTn and clinical routine variables, we aimed to build a digital tool to directly estimate the individual probability of MI, allowing for numerous hs-cTn assays.Methods: In 2,575 patients presenting to the emergency department with suspected MI, two ensembles of machine-learning models using single or serial concentrations of six different hs-cTn assays were derived to estimate the individual MI probability ( ARTEMIS model). Discriminative performance of the models was assessed using area under the receiver operating characteristic curve (AUC) and logLoss. Model performance was validated in an external cohort with 1688 patients and tested for global generalizability in 13 international cohorts with 23,411 patients.Results: Eleven routinely available variables including age, sex, cardiovascular risk factors, electrocardiography, and hs-cTn were included in the ARTEMIS models. In the validation and generalization cohorts, excellent discriminative performance was confirmed, superior to hs-cTn only. For the serial hs-cTn measurement model, AUC ranged from 0.92 to 0.98. Good calibration was observed. Using a single hs-cTn measurement, the ARTEMIS model allowed direct rule-out of MI with very high and similar safety but up to tripled efficiency compared to the guideline- recommended strategy.Conclusion We developed and validated diagnostic models to accurately estimate the individual probability of MI, which allow for variable hs-cTn use and flexible timing of resampling. Their digital application may provide rapid, safe and efficient personalized patient care.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Twerenbold, RaphaelUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Ctr Cardiovasc Sci, Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany. (author)
  • Ojeda, FranciscoUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany. (author)
  • Aldous, SallyChristchurch Hosp, Dept Cardiol, Christchurch, New Zealand. (author)
  • Allen, BrandonUniv Florida, Coll Med, Dept Emergency Med, Gainesville, FL USA. (author)
  • Mokhtari, A.Lund University,Lunds universitet,NPWT teknologin,Forskargrupper vid Lunds universitet,Skonsammare hjärtkirurgi,NPWT technology,Lund University Research Groups,Less invasive cardiac surgery,Skåne University Hospital(Swepub:lu)thor-ami (author)
  • Babel, HugoMedizincampus Davos, CardioCARE, Davos, Switzerland. (author)
  • Christenson, RobertUniv Maryland, Sch Med, Dept Pathol, Baltimore, MD USA. (author)
  • Cullen, LouiseRoyal Brisbane & Womens Hosp, Dept Emergency Med, Herston, Qld, Australia. (author)
  • Di Carluccio, EleonoraMedizincampus Davos, CardioCARE, Davos, Switzerland. (author)
  • Doudesis, DimitriosUniv Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Scotland. (author)
  • Ekelund, U.Lund University,Lunds universitet,Akutsjukvård,Forskargrupper vid Lunds universitet,Emergency medicine,Lund University Research Groups,Skåne University Hospital(Swepub:lu)mphy-uek (author)
  • Giannitsis, EvangelosHeidelberg Univ Hosp, Dept Cardiol, Heidelberg, Germany. (author)
  • Greenslade, JaimiRoyal Brisbane & Womens Hosp, Dept Emergency Med, Herston, Qld, Australia. (author)
  • Inoue, KenjiJuntendo Univ, Nerima Hosp, Tokyo, Japan. (author)
  • Jernberg, TomasKarolinska Institutet,Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. (author)
  • Kavsak, PeterMcMaster Univ, Dept Pathol & Mol Med, Hamilton, ON, Canada. (author)
  • Keller, TillKerckhoff Heart & Thorax Ctr, Dept Cardiol, Bad Nauheim, Germany. (author)
  • Lee, Kuan KenUniv Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Scotland. (author)
  • Lindahl, Bertil,1957-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)(Swepub:uu)belin227 (author)
  • Lorenz, ThiessUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany. (author)
  • Mahler, SimonWake Forest Sch Med, Dept Emergency Med, Winston Salem, NC USA. (author)
  • Mills, NicholasUniv Edinburgh, BHF Ctr Cardiovasc Sci, Edinburgh, Scotland. (author)
  • Mokhtari, ArashLund Univ, Skane Univ Hosp, Dept Internal Med & Emergency Med, Lund, Sweden.;Lund Univ, Skane Univ Hosp, Dept Cardiol, Lund, Sweden. (author)
  • Parsonage, WilliamQueensland Univ Technol, Australian Ctr Hlth Serv Innovat, Kelvin Grove, Australia. (author)
  • Pickering, JohnDept Med, Christchurch, New Zealand.;Univ Otago, Christchurch Hosp, Emergency Dept, Christchurch, New Zealand. (author)
  • Pemberton, ChristopherUniv Otago, Christchurch Heart Inst, Dept Med, Christchurch, New Zealand. (author)
  • Reich, ChristophHeidelberg Univ Hosp, Dept Cardiol, Heidelberg, Germany. (author)
  • Richards, A. MarkDept Med, Christchurch, New Zealand.;Univ Otago, Christchurch Hosp, Emergency Dept, Christchurch, New Zealand. (author)
  • Sandoval, YaderAbbott NW Hosp, Minneapolis Heart Inst, Minneapolis, MN USA.;Minneapolis Heart Inst Fdn, Minneapolis, MN USA. (author)
  • Than, Martin A.Dept Med, Christchurch, New Zealand.;Univ Otago, Christchurch Hosp, Emergency Dept, Christchurch, New Zealand. (author)
  • Toprak, BetülUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Ctr Cardiovasc Sci, Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany. (author)
  • Troughton, RichardUniv Otago, Christchurch Heart Inst, Dept Med, Christchurch, New Zealand. (author)
  • Worster, AndrewMcMaster Univ, Div Emergency Med, Hamilton, ON, Canada. (author)
  • Zeller, TanjaUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Ctr Cardiovasc Sci, Univ Heart & Vasc Ctr Hamburg, Hamburg, Germany. (author)
  • Ziegler, AndreasMedizincampus Davos, CardioCARE, Davos, Switzerland.;Univ KwaZulu Natal, Sch Math Stat & Comp Sci, Pietermaritzburg, South Africa. (author)
  • Blankenberg, StefanUniv Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.,University Medical Center Hamburg-Eppendorf,German Centre for Cardiovascular Research (author)
  • Apple, FS (author)
  • Than, MP (author)
  • Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr, Dept Cardiol, Martinistr 52, D-20246 Hamburg, Germany.;German Ctr Cardiovasc Res DZHK, Partner SiteHamburg Kiel Lubeck, Hamburg, Germany.;Univ Med Ctr Hamburg Eppendorf, Univ Heart & Vasc Ctr Hamburg, Populat Hlth Res Dept, Hamburg, Germany.;Monash Univ, Sch Publ Hlth & Prevent Med, Dept Epidemiol & Prevent Med, Melbourne, Australia.Monash University (creator_code:org_t)

Related titles

  • In:Clinical Research in Cardiology: Springer112, s. 1288-13011861-06841861-0692

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