Cardiovascular Risk Prediction Improvement Using Algorithm- or Formula-Based Pulse Wave Velocity: Analysis of CARTaGENE
Bibliographic record
Abstract
Background: Carotid-femoral pulse wave velocity (PWV) is the gold-standard measurement for aortic stiffness and a well-established surrogate marker for cardiovascular disease. Faster and less resource-intensive methods to estimate PWV (using either formulas or integrated pulse wave analysis algorithms) have been developed but their incremental predictive value for cardiovascular outcomes remains unclear. Methods: We studied individuals aged between 40 and 69 from the population based CARTaGENE cohort (Quebec, Canada). Baseline PWV was assessed using a previously described estimation formula (formula- based PWV, or f-PWV; using age, sex, and systolic blood pressure) or estimated with the ARCSolver algorithm from central waveform characteristics obtained with the SphygmoCor device (algorithm-based PWV, or a-PWV). Major adverse cardiovascular events (MACE: cardiovascular mortality, non- fatal stroke, non-fatal myocardial infarction) during a 10-year follow-up were obtained from medico-administrative databases. Cox proportional hazards models were employed to obtain associations between PWV and MACE after adjustment for existing cardiovascular risk prediction scores (ASCVD [from revised pooled cohort equations], SCORE-2). Results: 17,548 individuals were included and 2,263 experienced a MACE during follow-up. Mean PWV values at baseline were 8.4 ± 1.4 m/s (f-PWV) and 7.9 ± 1.3 m/s (a-PWV). Both f-PWV (HR= 1.52, 95% CI [1.47-1.58]) and a-PWV (HR=1.60 [1.54-1.66]) were predictive of MACE in unadjusted models. The association between a-PWV and MACE remained significant after adjustment for ASCVD (HR= 1.14 [1.08-1.20]) and but not after adjustment for SCORE-2 (HR= 1.06 [1.00-1.13]). In contrast, f-PWV was not associated with increased MACE after adjustment for either prediction score (HR= 1.02 [0.97-1.08] for ASCVD; HR= 0.95 [0.89-1.00] for SCORE-2). Similar trends were observed after stratification for tertiles of baseline cardiovascular risk. Conclusions: Algorithm-based PWV, but not formula-based PWV, improves cardiovascular prediction beyond what is achievable with recognized prediction tools.
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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 | 0.005 | 0.017 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 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".