Optimizing Cardiovascular Risk Management in Primary Care Using a Personalized eCoach Solution Enhanced by an Artificial Intelligence–Driven Clinical Prediction Model: Protocol from the Coronary Artery Disease Risk Estimation and Early Detection Consortium
Notice bibliographique
Résumé
BACKGROUND: Atherosclerotic cardiovascular disease poses a heavy burden on the population's health and health care costs. Identifying apparently healthy individuals at risk of developing cardiovascular diseases using clinical prediction models raises awareness, facilitates shared decision-making, and supports tailored management of disease prevention. In the CARRIER project, a personalized cardiovascular risk management (CVRM) eCoach approach is cocreated, in which identified individuals receive education, guidance, and monitoring to prevent atherosclerotic cardiovascular disease through existing interventions. In this approach, an artificial intelligence-driven clinical prediction model calculates the 10-year risk for atherosclerotic cardiovascular disease, which supports informed decision-making. OBJECTIVE: This study aims to assess the effectiveness of our CVRM eCoach approach through a 10-year risk calculation of atherosclerotic cardiovascular disease, including risk factors contributing to this risk. METHODS: This pretest-posttest interventional study provides the CVRM eCoach approach for 6 months to 100 apparently healthy individuals eligible for CVRM. The CVRM eCoach approach is a multicomponent eHealth solution, including a clinical prediction under intervention model that not only calculates the 10-year risk of cardiovascular disease through conventional risk factors (smoking, blood pressure, and lipid profile) and individual characteristics (age, gender, socioeconomic status, physical activity, and diet) but also calculates how the risk changes after hypothetical lifestyle or medical interventions. The CVRM eCoach approach includes features that encourage behavior change. Most of these features include goal setting, decision cards to help decide on an intervention, intervention monitoring, remote communication, and education, all accessible from one dashboard. A practice nurse or physician consults the individuals after risk calculation with the clinical prediction model and uses behavior change features, such as the decision cards, to support shared decision-making. Data are primarily collected via the eCoach, after which the 10-year risk for atherosclerotic cardiovascular disease and its components are analyzed using paired-sample analyses. RESULTS: Recruitment began in March 2024 and will continue until 100 participants have been recruited, which is expected in 2025. CONCLUSIONS: We anticipate that our CVRM eCoach approach will be valuable in the primary prevention setting. During the crucial initial first months of habit formation, factors such as education, regular check-ups via the eCoach, and clear risk communication could support individuals in sustaining their medical or lifestyle interventions. We hypothesize that there will be a slight to moderate reduction in the 10-year risk of atherosclerotic cardiovascular disease, which over time will lead to significant health improvements on a larger scale. TRIAL REGISTRATION: CCMO NL84584.096.23; https://onderzoekmetmensen.nl/nl/trial/56578.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,022 | 0,026 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,003 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,019 | 0,003 |
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 source (Gemma direct ou Codex distillé), 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 ».