Defining ascending aorta dilatation in pediatric bicuspid aortic valve: Comparison of known classical and new z-score nomograms, and anthropometric parameters indexing for its assessment
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Background Ascending aorta (AscAo) dilatation assessment and definition in pediatric bicuspid aortic valve (BAV) is challenging. We compared the Pediatric Heart Network (PHN) nomogram against the Halifax (HZ) one and analyzed their association with body surface area indexing (BSAI). Methods Echocardiographies from a national BAV registry were analyzed. AscAo and sinus of Valsalva, standardized using nomograms and BSAI, were compared by correlation and Bland-Altman tests. Nomogram +2 and + 3 z-scores thresholds contrasted against >21 mm/BSA-m2 by logistic regression and kappa agreement index. Age subgroup analysis was between adult-size (≥10 years and BSA ≥1.5 m 2 ) and small children. Results A total 3858 reports were analyzed. The PHN nomogram resulted in higher AscAo z-scores (median 1.516 versus 1.413). Nomogram correlation was Rho Spearman = 0.979 and Bland-Altman agreement bias was 0.302, with higher divergence in extreme z-scores. Patients ≥10 years and BSA ≥1.5 m 2 showed better concordance (bias −0.212 versus 0.440) despite similar correlation to the younger group. There was moderate but significant correlation amongst AscAo BSA-indexed diameters and PHN (Rho Spearman = 0.514, p < 0.001) and HZ nomograms (Rho Spearman = 0.366, p < 0.001), being higher in the older cohort than the younger, both by PHN (Rho Spearmam 0.961 versus 0.424) and HZ (Rho Spearman 0.952 versus 0.540). Higher area under the curve was obtained by PHN. A lower percentage was classified as dilated with PHN than by BSA-I in the adult-size cohort, but not in younger patients. Discussion There was good correlation and concordance between HZ and PHN nomograms, the latter resulting in higher z-scores. PHN has better agreement with BSA-I than HZ, with the PHN > +3 z-score threshold being the highest predictor for BSA-I dilatation definition, also showing higher specificity and sensitivity. BSA-I classified fewer patients as dilated than nomograms in adult-sized children but not in the younger cohort. Clinicians should be aware of this effect of BSA when normalizing diameters.
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.
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 it