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Record W3113162207 · doi:10.1101/2020.12.07.20241109

Machine learning for analysis of active stand responses in older adults with vasovagal syncope

2020· preprint· en· W3113162207 on OpenAlexaff
Michelle Kwok, Hugh Nolan, Chie Wei Fan, Clodagh O’Dwyer, Rose Anne Kenny, Ciarán Finucane

Bibliographic record

VenuemedRxiv · 2020
Typepreprint
Languageen
FieldMedicine
TopicCardiovascular Syncope and Autonomic Disorders
Canadian institutionsUniversity of New Brunswick
Fundersnot available
KeywordsVasovagal syncopeMedicineSupine positionCardiologyStroke volumeHeart rateInternal medicineHemodynamicsBlood pressureAnesthesiaSyncope (phonology)

Abstract

fetched live from OpenAlex

Abstract Objectives To assess 1) differences in the hemodynamic response to the active stand test in older adults with a clinical diagnosis of vasovagal syncope compared to age-matched controls 2) if the active stand test combined with machine learning approaches can be used to identify the presence of vasovagal syncope in older adults. Approach Adults aged 50 and over (Vasovagal Syncope N=46 Age=66.9±10.3; Control N=86 Age=65.3±9.5) completed an active stand test. Multiple features were extracted to characterize the hemodynamic responses to the active stand test and were compared between groups. Classification was performed using machine learning algorithms including linear discriminant analysis, quadratic discriminant analysis, support vector machine and an ensemble majority vote classifier. Main Results Subjects with vasovagal syncope demonstrated a higher resting (supine) heart rate (69.8±13.1 bpm vs 63.3±12.1 bpm; P=0.007), a smaller initial systolic blood pressure drop (−20.2±20.1% vs −27.3±17.5%; P=0.005), larger drops in stroke volume (−14.7±24.0% vs −2.7±23.3%; P=0.010) and cardiac output (−6.4±18.5% vs 5.8±22.3%;P<0.001) and a larger increase in total peripheral resistance (8.1±30.4% vs −6.03±22.8%; P=0.002) compared to controls. A majority vote classifier identified the presence of vasovagal syncope with 82.6% sensitivity, 76.8% specificity, and average accuracy of 78.9%. Significance Older adults with vasovagal syncope display a unique hemodynamic and autonomic response to active standing characterized by relative autonomic hypersensitivity and larger drops in cardiac output compared to age-matched controls. With suitable machine learning algorithms, the active stand test holds the potential to be used to screen older adults for reflex syncopes and hypotensive susceptibility potentially reducing test time, cost, and patient discomfort. More broadly this paper presents a machine learning framework to support use of the active stand test for classification of clinical outcomes of interest.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.150
Threshold uncertainty score0.957

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.017
GPT teacher head0.273
Teacher spread0.256 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

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".

Quick stats

Citations4
Published2020
Admission routes1
Has abstractyes

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