P4208Impact of international guidelines' differing approaches to the risk stratification of patients with suspected stable angina: Insights form PROMISE and SCOT-HEART
Bibliographic record
Abstract
Background: Despite consensus that non-invasive testing is of limited utility in low-risk individuals with stable angina, international guidelines have adopted differing approaches to defining this cohort. Purpose: We compared the efficiency and safety of major guidelines for the assessment of stable angina due to coronary artery disease (CAD) including risk-based (American College of Cardiology/American Heart Association [ACC/AHA] and European Society of Cardiology [ESC]) and symptom-focused (National Institute for Health and Care Excellence [NICE]) strategies. Methods: Patient-level data was obtained from the Prospective Multicentre Imaging Study for Evaluation of Chest Pain (PROMISE) and Scottish Computed Tomography of the Heart (SCOT-HEART) trials. Pre-test probability was assessed according to published criteria and patients dichotomised into low-risk and intermediate/high risk groups according to the definitions from each guideline. The primary endpoint was the presence of obstructive CAD on computed tomography coronary angiography (CTCA). The secondary endpoints were coronary revascularisation at 90 days and cardiovascular death or non-fatal myocardial infarction (CVD/MI) up to 3 years. To confirm guideline utility in distinct clinical settings, the study cohorts were analysed separately.
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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 | 0.078 | 0.210 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
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".