Heart failure & cardiomyopathiesCohort study
Factors Impacting Physician Prognostic Accuracy in Heart Failure Patients With Reduced Left Ventricular Ejection Fraction
- Prospective cohort study
- multicentre
Authors' conclusion
Discrepant physician and model predictions were more frequent in cases with perceived increased risk. Model predictions outperform physicians even when they are confident in their predictions.
Study context
- Population
- Outpatients with heart failure (HF) from 11 HF clinics
- Participants
- 1,643 outpatients · 11 HF clinics
- Exposure
- Physician vs model 1-year mortality predictions
- Outcome
- Concordance between physician and model predictions; factors associated with discrepancy
- Follow-up
- 1 year
Main finding
As reported in the abstract
Discrepant physician vs model predictions
Each group vs seattle HF ModelOdds ratio (95% CI)
Female HF cardiologistsmale patients; 26% more likely discrepant
0.74(0.58–0.94)
HF cardiologists, Black patients33% more likely discrepant
0.67(0.45–0.99)
- Estimates discrepant between model and physician, mainly physician risk overestimation
- One-half
- Discrepancy in low-risk patients
- 38%
- Discrepancy in high-risk patients
- ∼75%
Observational data: associations, not effects.
Further findings
1-year event rate
- 1-year event rate
- 10% (95% CI: 8%-12%)
Calibration, high-confidence estimates only
- Inferior calibration to the model, risk overestimation across risk groups
Original publication
Factors Impacting Physician Prognostic Accuracy in Heart Failure Patients With Reduced Left Ventricular Ejection Fraction. JACC Heart Fail. Published 27 March 2024. doi:10.1016/j.jchf.2024.02.009
Summarised from the published abstract; every number is checked against it