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Machine Learning Adds Little to MI Prognostication

email article Machine learning (ML) algorithms developed to predict in-hospital mortality after acute MI offered more meaningful gains in model calibration than in accuracy, researchers found. Parsing through data on 29 variables from the American College of Cardiology (ACC) Chest Pain-MI Registry, extreme gradient descent boosting (XGBoost) and meta-classifier models offered no substantive improvement in discrimination compared with standard logistic regression modeling (C-statistics 0.90 for both vs 0.89), reported Harlan Krumholz, MD, SM, of Yale School of Medicine, and colleagues. However, the two ML models showed nearly perfect agreement between observed and predicted risk across the risk spectrum. Of the people deemed moderate-to-high risk in logistic regression, 27% were more accurately reclassified as low risk by the XGBoost model and 25% by the meta-classifier model both more consistent with the observed event rates.

HEALTH CARE BRIEFING: Study Offers Look at How Vaccines Compare

March 9, 2021 6:11 AM By Brandon Lee Clues to how the three available Covid-19 vaccines compare could come through a real-world study on the long-term effects of inoculation, offering a chance to subdue fears over whether one shot is better than another. Thousands of health-care workers will be surveyed in the next few years on their health and well-being as part of a study known as “HERO-Together.” The first phase of the study, led by the Duke Clinical Research Institute, will address vaccine hesitancy, but over time it will also address safety and health outcomes, with the potential to determine whether there are any meaningful differences among the vaccines.

CABANA Supports Use of AF Ablation in Patients With Heart Failure

February 12, 2021 Participants in the CABANA trial who had stable heart failure mostly with preserved ejection fraction in addition to atrial fibrillation (AF) at baseline fared better when they underwent catheter ablation than when they were started on medical therapy alone, a detailed subgroup analysis shows. Those randomized to ablation had lower risks of mortality, the primary composite outcome of the trial (death, disabling stroke, serious bleeding, or cardiac arrest), and AF recurrence, as well as improved quality of life, according to researchers led by Douglas Packer, MD (Mayo Clinic Hospital St. Marys Campus, Rochester, MN), principal investigator for the trial.

Effect of Discontinuing vs Continuing Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers on Days Alive and Out of the Hospital in Patients Admitted With COVID-19: A Randomized Clinical Trial | Critical Care Medicine | JAMA

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