Feasibility of novel points-based health questionnaire utilised in a nationwide cardiac screening programme for young individuals
Notice bibliographique
Résumé
Abstract Background Widely used cardiac screening protocols in the United States and the United Kingdom include health questionnaires (HQ) with open-ended questions that require an on-site physician to differentiate between symptoms considered benign from pathological, and in turn limit the number of false-positive referrals. The on-site physician is a costly, limited resource and compromises the cost-effectiveness of the screening protocol which in turn limits its application on a large-population scale. Purpose The points-based Cardiac Risk in the Young - British Columbia health questionnaire (CRY-BC HQ) was designed to be implemented without an on-site physician and provides a quantitative assessment of cardiovascular symptoms (syncope, chest pain, palpitations, and breathlessness). These symptoms are scored independently of one another using negatively and positively-weighted qualifying statements e.g. Syncope: It occurred very soon after standing up from a seated/lying position [scores -1); Syncope: It occurred during exercise and was not related to head trauma [scores +20]. A score over a pre-determined threshold was considered abnormal, warranting secondary evaluation. The family history component screens for inherited cardiac conditions and young sudden cardiac arrest/death, with any positive response to a first-degree relative considered abnormal, warranting secondary evaluation. We evaluated the effectiveness of the CRY-BC HQ by comparing it to a gold standard – a physician’s interpretation of symptoms and family history reported during a clinical consultation at cardiac screening. Methods Over a 6-month period, 10,590 consecutive individuals, aged 14 to 35 years, underwent voluntary cardiac screening as part of Cardiac Risk in the Young's (CRY) nationwide programme. Initial evaluation included the standard CRY HQ (widely used format of questions), 12-lead ECG and a clinical consultation. The consulting physician was blinded to the outcome of the CRY-BC HQ which completed at the same time of the standard CRY HQ. Results A total of 5,916 (56%) individuals reported a cardiovascular symptom and/or family history of heart disease on their HQ which required interpretation by the consulting physician. The CRY-BC HQ outcome matched the consulting physician’s interpretation of symptoms for 10,199 (96%) individuals, and family history for 10,548 (99%) individuals. These figures exceed the pre-determined 95% standard and suggests the CRY-BC HQ performs well compared to CRY’s standard practice. Conclusions A novel points-based HQ performs effectively compared to an on-site physician’s interpretation of symptoms and family history, indicating potentially significant cost savings in the context of mass screening. Cost savings could be used to screen and identify a greater number of individuals with quiescent cardiac disease. Figure 2- Example question: Syncope.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,026 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».