Updated Clinical Practice Guidelines on Heart Failure: An International Alignment
Bibliographic record
Abstract
The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) are pleased to announce the publication of two updated clinical practice guidelines on management of patients with heart failure, which have been produced in collaboration with the Heart Failure Society of America (HFSA) and the Heart Failure Association (HFA) of the ESC. The introduction of an angiotensin receptor-neprilysin inhibitor (ARNI), valsartan/sacubitril, and a sinoatrial node modulator, ivabradine, when applied judiciously, complement established pharmacological and device-based therapies, representing milestones in the evolution of care for patients with heart failure. Accordingly, the writing committees of the “ESC 2016 Guidelines on the Diagnosis and Treatment of Acute and Chronic Heart Failure Developed With the Special Contribution of the HFA”1 and the “2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure”2 concurrently developed recommendations for the incorporation of these therapies into clinical practice. The ESC guidelines are a complete revision of the “ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure (2012) Developed With the Special Contribution of the HFA”.3 The ACC/AHA/HFSA document, developed in partnership with the HFSA, is part of a Focused Update of the “2013 ACCF/AHA Guideline for the Management of Heart Failure”4 that will be published within the next year. Each writing committee surveyed the evidence independently and constructed similar recommendations, which were then shared between the organizations. Given the robust processes used by both expert writing committees to review the evidence and develop these recommendations and the concordance between them, the organizations agreed to publish them concurrently to unify the message, minimize confusion, and improve and standardize the care of patients with heart failure. The officers of the ACC, AHA, and ESC and their respective guideline oversight committees meet regularly to discuss opportunities for coordination and alignment on overlapping topics and evolution of the methodology used to gather and evaluate scientific evidence. The objective is to promote optimal care for patients with all forms of cardiovascular disease to improve outcomes and enhance quality of life around the world. The new documents represent an important step in this direction. The European Society of Cardiology requests that this document be cited as follows: Antman EM, Bax J, Chazal RA, Creager MA, Filippatos G, Halperin JL, Houser S, Lindenfeld J, Pinto FJ, Vardas P, Walsh MN, Williams KA Sr, Zamorano JL. Updated clinical practice guidelines on heart failure: an international alignment. Eur J Heart Fail 2016;18:976. This article has been copublished in Circulation, Journal of Cardiac Failure, the Journal of the American College of Cardiology and the European Heart Journal. Copies: This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org), the American Heart Association (professional.heart.org), the Heart Failure Society of America (www.hfsa.org), and the European Society of Cardiology (www.escardio.org/guidelines). For copies of this document, please contact the John Wiley & Sons, Reprint Department via e-mail ([email protected]). Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the European Society of Cardiology. For permission requests, please contact John Wiley & Sons, Permissions Department ([email protected]).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.024 | 0.087 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.012 | 0.011 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.006 | 0.005 |
| Open science | 0.005 | 0.005 |
| Research integrity | 0.007 | 0.012 |
| Insufficient payload (model declined to judge) | 0.024 | 0.016 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".