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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. ....
email article Before COVID-19, I left the practice of medicine for what would turn out to become an entire year. While away, I found a new way of seeing our hearts and bodies as humans in the medical profession, allowing me to return. Here are five lessons I learned: 1. Perfectionism doesn t make you perfect If perfectionism isn t an unwritten rule in our profession, it s, at minimum, a heavily reinforced personality tendency. When I first faced my perfectionism, I tried to argue it was a good thing. Of course, I m a perfectionist I m a physician. We have to be perfectionists. If we re not, people die. ....
email article An international committee proposed a universal definition for heart failure (HF) and two standard classifications that go beyond reduced and preserved left ventricular ejection fraction (LVEF). HF is a clinical syndrome with symptoms and or signs caused by a structural and or functional cardiac abnormality and corroborated by elevated natriuretic peptide levels and or objective evidence of pulmonary or systemic congestion, according to the consensus document from the Heart Failure Society of America (HFSA), European Society of Cardiology, and Japanese Heart Failure Society. This is a slight difference from the definition of HF from the American College of Cardiology (ACC) and American Heart Association: a complex clinical syndrome that results from any structural or functional impairment of ventricular filling or ejection of blood. ....
The American College of Cardiology abandoned plans to have an in-person component to its meeting in May. Bernard Lown, MD heart defibrillator inventor, pioneer in lifestyle medicine for cardiovascular disease, and peace activist died at 99 after suffering from congestive heart failure. ( AP) JAMA Neurology) Quality measures? Meh, say interventional cardiologists. Survey says feedback from case conferences and informal peer interactions are more useful. ( American Heart Journal) After severe COVID-19 with elevated troponin, about a quarter of patients had what looked like myocarditis and about a quarter had infarcts or ischemia. ( European Heart Journal) CT surveillance of abdominal aortic aneurysms smaller than 4.25 cm can be safely pushed to at least 2 years, analysis of randomized trial data suggested. ( ....