Heart failure & cardiomyopathies
Predicting 1-Year Mortality in Outpatients With Heart Failure With Reduced Left Ventricular Ejection Fraction: Do Empiric Models Outperform Physician Intuitive Estimates? A Multicenter Cohort Study
Authors' conclusion
Family doctors and HF cardiologists showed adequate risk discrimination, with however substantial overestimation of absolute risk. Predictive models showed higher accuracy.
Study context
- Population
- Consecutive consented outpatients with heart failure (HF) with reduced LVEF (<40%), Canada9% had an event
- Participants
- 1,643 participants
- Exposure
- Physician intuitive estimates vs empiric models (Seattle HF Model (SHFM), MAGGIC, HF Meta-Score) for predicting 1-year mortality
- Outcome
- Accuracy of predictions (discrimination, calibration, risk reclassification) of composite of mortality, urgent ventricular assist device implant or heart transplant
- Follow-up
- 1 year
Methodological detailsmulticenter, 11 HF clinics in 5 provinces in Canada
- Multicenter
- 11 HF clinics in 5 provinces in Canada
Main finding
As reported in the abstract
Discrimination (C statistic) · 1-year follow-up
SHFM
0.76
C statistic
HF Meta-Score
0.73
C statistic
MAGGIC
0.70
C statistic
HF cardiologists
0.75
C statistic
Family doctors
0.73
C statistic
- Both physician groups overestimated risk in low- and high-risk patients (poor calibration)
- >10%
Observational data: associations, not effects.
Further findings
Risk reclassification, SHFM vs physicians
- Patients without events: SHFM better classified vs HF cardiologists
- 51%
- Patients without events: SHFM better classified vs family doctors
- 43%
- Patients with events: SHFM erroneously assigned lower risk vs HF cardiologists
- 44%
- Patients with events: SHFM erroneously assigned lower risk vs family doctors
- 34%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Predicting 1-Year Mortality in Outpatients With Heart Failure With Reduced Left Ventricular Ejection Fraction: Do Empiric Models Outperform Physician Intuitive Estimates? A Multicenter Cohort Study. Circ Heart Fail. Published 20 June 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →