How Good Are Cardiologists at Predicting Major Adverse Events in Fontan Patients?
Authors' conclusion
Cardiologists are marginally able to predict which Fontan patients are at risk for MAE over a year. There was overlap between factors associated with a cardiologist's prediction of risk and observed MAE, namely the use of diuretic/beta-blocker.
Study context
- Population
- Patients ≥10 years with lateral tunnel or extracardiac Fontan
- Participants
- 146 patients
- Exposure
- Cardiologist prediction of MAE vs observed MAE
- Good Fontann = 99
- Cardiologist-predicted MAEn = 47
- Outcome
- Agreement between cardiologist predictions of MAE and observed MAE (simple kappa coefficient)
- Follow-up
- 12 months
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Agreement of cardiologist prediction with observed MAE
Simple kappa coefficient (95% CI 0.02-0.32); prediction 17% better than random chance
0.17
Observed MAE
17
12%
Observational data: associations, not effects.
Further findings
Factors associated with cardiologist-predicted MAE (multivariable model, N = 47)
- Diuretic/beta-blocker use
- P ≤ 0.001
- Systolic dysfunction
- P = 0.005
Factors associated with observed MAE (multivariable model, N = 17)
- Prior unplanned cardiac admission
- P = 0.006
- Diuretic/beta-blocker use
- P = 0.028
- ≥moderate atrioventricular valve regurgitation
- P = 0.049
Original publication
How Good Are Cardiologists at Predicting Major Adverse Events in Fontan Patients? JACC Adv. Published 24 November 2023. doi:10.
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