P5233Is a simpler approach to the diagnosis of cardiotoxicity accurate? Comparison of single-view and standard assessment of global longitudinal strain
Bibliographic record
Abstract
Background: Global longitudinal strain (GLS) is a sensitive marker of LV dysfunction that facilitates early detection of cancer therapeutics related cardiac dysfunction (CTRCD). Standard GLS is derived from 3 apical views. However, as patients require repeated testing and CTRCD is a diffuse process, single view GLS could improve efficiency. Purpose: We sought whether 4 chamber view GLS (4CV_LS) could substitute GLS for the detection of CTRCD in an international multicenter study. Methods: In patients receiving Anthracycline-based chemotherapy, enrolled from 17 international institutions (7 Europe, 2 North America, 5 Asia and 3 Australia), ejection fraction (EF), GLS and 4CV_LS were measured at baseline and follow-up, and the differences between them were calculated. Asymptomatic CTRCD was defined as EF>0.10 decrease with to <0.55, or GLS>12% decrease. A Bland-Altman plot (BA plot) was used for evaluation of concordance. Results: Of 108 patients (54±13 years, 101 women), 95 had breast cancer, 13 had hematologic malignancy. There were good correlations between GLS and 4CV_LS at baseline and follow-up (r=0.86 and 0.89, both p<0.0001). BA plots demonstrated minimal bias (0.21 at baseline; 0.03 at follow-up) but modest limits of agreement (2.54% and 2.19%). Of 47 patients developing CTRCD, 4CV_LS yielded 15 (14%) false negatives and 9 (8%) false positives, resulting in a discordance rate of 22% to detect CTRCD (Figure).
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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 | 0.011 | 0.024 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".