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8. Critical appraisal of artificial intelligence-based prediction models for cardiovascular disease

Author

Van Smeden, M., Heinze, G., Van Calster, B., Asselbergs, F. W., Vardas, P. E., Bruining, N., De Jaegere, P., Moore, J. H., Denaxas, S., Boulesteix, A. L., Moons, K. G. M., Van Smeden, M., Heinze, G., Van Calster, B., Asselbergs, F. W., Vardas, P. E., Bruining, N., De Jaegere, P., Moore, J. H., Denaxas, S., Boulesteix, A. L., and Moons, K. G. M.

Abstract

The medical field has seen a rapid increase in the development of artificial intelligence (AI)-based prediction models. With the introduction of such AI-based prediction model tools and software in cardiovascular patient care, the cardiovascular researcher and healthcare professional are challenged to understand the opportunities as well as the limitations of the AI-based predictions. In this article, we present 12 critical questions for cardiovascular health professionals to ask when confronted with an AI-based prediction model. We aim to support medical professionals to distinguish the AI-based prediction models that can add value to patient care from the AI that does not.

Published
2022

28. Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine

Author

Gerotziafas G. T., Catalano M., Colgan M. -P., Pecsvarady Z., Wautrecht J. C., Fazeli B., Olinic D. -M., Farkas K., Elalamy I., Falanga A., Fareed J., Papageorgiou C., Arellano R. S., Agathagelou P., Antic D., Auad L., Banfic L., Bartolomew J. R., Benczur B., Bernardo M. B., Boccardo F., Cifkova R., Cosmi B., De Marchi S., Dimakakos E., Dimopoulos M. A., Dimitrov G., Durand-Zaleski I., Edmonds M., El Nazar E. A., Erer D., Esponda O. L., Gresele P., Gschwandtner M., Gu Y., Heinzmann M., Hamburg N. M., Hamade A., Jatoi N. -A., Karahan O., Karetova D., Karplus T., Klein-Weigel P., Kolossvary E., Kozak M., Lefkou E., Lessiani G., Liew A., Marcoccia A., Marshang P., Marakomichelakis G., Matuska J., Moraglia L., Pillon S., Poredos P., Prior M., Salvador D. R. K., Schlager O., Schernthaner G., Sieron A., Spaak J., Spyropoulos A., Sprynger M., Suput D., Stanek A., Stvrtinova V., Szuba A., Tafur A., Vandreden P., Vardas P. E., Vasic D., Vikkula M., Wennberg P., Zhai Z., Bikdeli B., Guo Y., Harenberg J., Hu Y., Lip G. Y. H., Roldan V., Gerotziafas, G, Catalano, M, Colgan, M, Pecsvarady, Z, Wautrecht, J, Fazeli, B, Olinic, D, Farkas, K, Elalamy, I, Falanga, A, Fareed, J, Papageorgiou, C, Arellano, R, Agathagelou, P, Antic, D, Auad, L, Banfic, L, Bartolomew, J, Benczur, B, Bernardo, M, Boccardo, F, Cifkova, R, Cosmi, B, De Marchi, S, Dimakakos, E, Dimopoulos, M, Dimitrov, G, Durand-Zaleski, I, Edmonds, M, El Nazar, E, Erer, D, Esponda, O, Gresele, P, Gschwandtner, M, Gu, Y, Heinzmann, M, Hamburg, N, Hamade, A, Jatoi, N, Karahan, O, Karetova, D, Karplus, T, Klein-Weigel, P, Kolossvary, E, Kozak, M, Lefkou, E, Lessiani, G, Liew, A, Marcoccia, A, Marshang, P, Marakomichelakis, G, Matuska, J, Moraglia, L, Pillon, S, Poredos, P, Prior, M, Salvador, D, Schlager, O, Schernthaner, G, Sieron, A, Spaak, J, Spyropoulos, A, Sprynger, M, Suput, D, Stanek, A, Stvrtinova, V, Szuba, A, Tafur, A, Vandreden, P, Vardas, P, Vasic, D, Vikkula, M, Wennberg, P, Zhai, Z, Bikdeli, B, Guo, Y, Harenberg, J, Hu, Y, Lip, G, Roldan, V, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), CHU Tenon [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Trinity College Dublin, Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Mashhad University of Medical Sciences, Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Conservatoire National des Arts et Métiers [CNAM] (CNAM)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Gerotziafas G.T., Catalano M., Colgan M.-P., Pecsvarady Z., Wautrecht J.C., Fazeli B., Olinic D.-M., Farkas K., Elalamy I., Falanga A., Fareed J., Papageorgiou C., Arellano R.S., Agathagelou P., Antic D., Auad L., Banfic L., Bartolomew J.R., Benczur B., Bernardo M.B., Boccardo F., Cifkova R., Cosmi B., De Marchi S., Dimakakos E., Dimopoulos M.A., Dimitrov G., Durand-Zaleski I., Edmonds M., El Nazar E.A., Erer D., Esponda O.L., Gresele P., Gschwandtner M., Gu Y., Heinzmann M., Hamburg N.M., Hamade A., Jatoi N.-A., Karahan O., Karetova D., Karplus T., Klein-Weigel P., Kolossvary E., Kozak M., Lefkou E., Lessiani G., Liew A., Marcoccia A., Marshang P., Marakomichelakis G., Matuska J., Moraglia L., Pillon S., Poredos P., Prior M., Salvador D.R.K., Schlager O., Schernthaner G., Sieron A., Spaak J., Spyropoulos A., Sprynger M., Suput D., Stanek A., Stvrtinova V., Szuba A., Tafur A., Vandreden P., Vardas P.E., Vasic D., Vikkula M., Wennberg P., Zhai Z., Bikdeli B., Guo Y., Harenberg J., Hu Y., Lip G.Y.H., Roldan V., and UCL - SSS/DDUV/GEHU - Génétique

Subjects
030204 cardiovascular system & hematology, antithrombotic, antiplatelet, chemistry.chemical_compound, 0302 clinical medicine, Rivaroxaban, Risk Factors, cardiovascular disease, Thrombophilia, 030212 general & internal medicine, antiplatelets, low-molecular-weight heparin, Societies, Medical, Low-Molecular-Weight, Hematology, 3. Good health, Europe, Cardiovascular Diseases, Thrombosi, Practice Guidelines as Topic, Position Paper, Risk assessment, medicine.drug, Human, medicine.medical_specialty, anticoagulants, medicine.drug_class, DOAC, Cardiology, Low molecular weight heparin, peripheral artery disease, deep vein thrombosis, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Medical, medicine, Humans, COVID-19 - cardiovascular disease - peripheral artery disease - deep vein thrombosis - antithrombotic - antiplatelets - anticoagulants - low-molecular-weight heparin - DOAC, Intensive care medicine, Contraindication, Angiology, Inflammation, Vascular disease, business.industry, Heparin, SARS-CoV-2, Risk Factor, anticoagulant, deep vein thrombosi, COVID-19, Thrombosis, Heparin, Low-Molecular-Weight, medicine.disease, COVID-19 Drug Treatment, chemistry, Betrixaban, business, Societies
Abstract

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital discharge using the IMPROVE-D-dimer score and prolonged post-discharge thromboprophylaxis with rivaroxaban, betrixaban, or LMWH.

Published
2020

30. Guidance for the Management of Patients with Vascular Disease or Cardiovascular Risk Factors and COVID-19: Position Paper from VAS-European Independent Foundation in Angiology/Vascular Medicine

Author

Gerotziafas, G, Catalano, M, Colgan, M, Pecsvarady, Z, Wautrecht, J, Fazeli, B, Olinic, D, Farkas, K, Elalamy, I, Falanga, A, Fareed, J, Papageorgiou, C, Arellano, R, Agathagelou, P, Antic, D, Auad, L, Banfic, L, Bartolomew, J, Benczur, B, Bernardo, M, Boccardo, F, Cifkova, R, Cosmi, B, De Marchi, S, Dimakakos, E, Dimopoulos, M, Dimitrov, G, Durand-Zaleski, I, Edmonds, M, El Nazar, E, Erer, D, Esponda, O, Gresele, P, Gschwandtner, M, Gu, Y, Heinzmann, M, Hamburg, N, Hamade, A, Jatoi, N, Karahan, O, Karetova, D, Karplus, T, Klein-Weigel, P, Kolossvary, E, Kozak, M, Lefkou, E, Lessiani, G, Liew, A, Marcoccia, A, Marshang, P, Marakomichelakis, G, Matuska, J, Moraglia, L, Pillon, S, Poredos, P, Prior, M, Salvador, D, Schlager, O, Schernthaner, G, Sieron, A, Spaak, J, Spyropoulos, A, Sprynger, M, Suput, D, Stanek, A, Stvrtinova, V, Szuba, A, Tafur, A, Vandreden, P, Vardas, P, Vasic, D, Vikkula, M, Wennberg, P, Zhai, Z, Bikdeli, B, Guo, Y, Harenberg, J, Hu, Y, Lip, G, Roldan, V, Gerotziafas G. T., Catalano M., Colgan M. -P., Pecsvarady Z., Wautrecht J. C., Fazeli B., Olinic D. -M., Farkas K., Elalamy I., Falanga A., Fareed J., Papageorgiou C., Arellano R. S., Agathagelou P., Antic D., Auad L., Banfic L., Bartolomew J. R., Benczur B., Bernardo M. B., Boccardo F., Cifkova R., Cosmi B., De Marchi S., Dimakakos E., Dimopoulos M. A., Dimitrov G., Durand-Zaleski I., Edmonds M., El Nazar E. A., Erer D., Esponda O. L., Gresele P., Gschwandtner M., Gu Y., Heinzmann M., Hamburg N. M., Hamade A., Jatoi N. -A., Karahan O., Karetova D., Karplus T., Klein-Weigel P., Kolossvary E., Kozak M., Lefkou E., Lessiani G., Liew A., Marcoccia A., Marshang P., Marakomichelakis G., Matuska J., Moraglia L., Pillon S., Poredos P., Prior M., Salvador D. R. K., Schlager O., Schernthaner G., Sieron A., Spaak J., Spyropoulos A., Sprynger M., Suput D., Stanek A., Stvrtinova V., Szuba A., Tafur A., Vandreden P., Vardas P. E., Vasic D., Vikkula M., Wennberg P., Zhai Z., Bikdeli B., Guo Y., Harenberg J., Hu Y., Lip G. Y. H., Roldan V., Gerotziafas, G, Catalano, M, Colgan, M, Pecsvarady, Z, Wautrecht, J, Fazeli, B, Olinic, D, Farkas, K, Elalamy, I, Falanga, A, Fareed, J, Papageorgiou, C, Arellano, R, Agathagelou, P, Antic, D, Auad, L, Banfic, L, Bartolomew, J, Benczur, B, Bernardo, M, Boccardo, F, Cifkova, R, Cosmi, B, De Marchi, S, Dimakakos, E, Dimopoulos, M, Dimitrov, G, Durand-Zaleski, I, Edmonds, M, El Nazar, E, Erer, D, Esponda, O, Gresele, P, Gschwandtner, M, Gu, Y, Heinzmann, M, Hamburg, N, Hamade, A, Jatoi, N, Karahan, O, Karetova, D, Karplus, T, Klein-Weigel, P, Kolossvary, E, Kozak, M, Lefkou, E, Lessiani, G, Liew, A, Marcoccia, A, Marshang, P, Marakomichelakis, G, Matuska, J, Moraglia, L, Pillon, S, Poredos, P, Prior, M, Salvador, D, Schlager, O, Schernthaner, G, Sieron, A, Spaak, J, Spyropoulos, A, Sprynger, M, Suput, D, Stanek, A, Stvrtinova, V, Szuba, A, Tafur, A, Vandreden, P, Vardas, P, Vasic, D, Vikkula, M, Wennberg, P, Zhai, Z, Bikdeli, B, Guo, Y, Harenberg, J, Hu, Y, Lip, G, Roldan, V, Gerotziafas G. T., Catalano M., Colgan M. -P., Pecsvarady Z., Wautrecht J. C., Fazeli B., Olinic D. -M., Farkas K., Elalamy I., Falanga A., Fareed J., Papageorgiou C., Arellano R. S., Agathagelou P., Antic D., Auad L., Banfic L., Bartolomew J. R., Benczur B., Bernardo M. B., Boccardo F., Cifkova R., Cosmi B., De Marchi S., Dimakakos E., Dimopoulos M. A., Dimitrov G., Durand-Zaleski I., Edmonds M., El Nazar E. A., Erer D., Esponda O. L., Gresele P., Gschwandtner M., Gu Y., Heinzmann M., Hamburg N. M., Hamade A., Jatoi N. -A., Karahan O., Karetova D., Karplus T., Klein-Weigel P., Kolossvary E., Kozak M., Lefkou E., Lessiani G., Liew A., Marcoccia A., Marshang P., Marakomichelakis G., Matuska J., Moraglia L., Pillon S., Poredos P., Prior M., Salvador D. R. K., Schlager O., Schernthaner G., Sieron A., Spaak J., Spyropoulos A., Sprynger M., Suput D., Stanek A., Stvrtinova V., Szuba A., Tafur A., Vandreden P., Vardas P. E., Vasic D., Vikkula M., Wennberg P., Zhai Z., Bikdeli B., Guo Y., Harenberg J., Hu Y., Lip G. Y. H., and Roldan V.

Abstract

COVID-19 is also manifested with hypercoagulability, pulmonary intravascular coagulation, microangiopathy, and venous thromboembolism (VTE) or arterial thrombosis. Predisposing risk factors to severe COVID-19 are male sex, underlying cardiovascular disease, or cardiovascular risk factors including noncontrolled diabetes mellitus or arterial hypertension, obesity, and advanced age. The VAS-European Independent Foundation in Angiology/Vascular Medicine draws attention to patients with vascular disease (VD) and presents an integral strategy for the management of patients with VD or cardiovascular risk factors (VD-CVR) and COVID-19. VAS recommends (1) a COVID-19-oriented primary health care network for patients with VD-CVR for identification of patients with VD-CVR in the community and patients' education for disease symptoms, use of eHealth technology, adherence to the antithrombotic and vascular regulating treatments, and (2) close medical follow-up for efficacious control of VD progression and prompt application of physical and social distancing measures in case of new epidemic waves. For patients with VD-CVR who receive home treatment for COVID-19, VAS recommends assessment for (1) disease worsening risk and prioritized hospitalization of those at high risk and (2) VTE risk assessment and thromboprophylaxis with rivaroxaban, betrixaban, or low-molecular-weight heparin (LMWH) for those at high risk. For hospitalized patients with VD-CVR and COVID-19, VAS recommends (1) routine thromboprophylaxis with weight-adjusted intermediate doses of LMWH (unless contraindication); (2) LMWH as the drug of choice over unfractionated heparin or direct oral anticoagulants for the treatment of VTE or hypercoagulability; (3) careful evaluation of the risk for disease worsening and prompt application of targeted antiviral or convalescence treatments; (4) monitoring of D-dimer for optimization of the antithrombotic treatment; and (5) evaluation of the risk of VTE before hospital dischar

Published
2020

37. CODE-EHR best-practice framework for the use of structured electronic health-care records in clinical research

Author

Kotecha, Dipak, Asselbergs, Folkert W, Achenbach, Stephan, Anker, Stefan D, Atar, Dan, Baigent, Colin, Banerjee, Amitava, Beger, Birgit, Brobert, Gunnar, Casadei, Barbara, Ceccarelli, Cinzia, Cowie, Martin R, Crea, Filippo, Cronin, Maureen, Denaxas, Spiros, Derix, Andrea, Fitzsimons, Donna, Fredriksson, Martin, Gale, Chris P, Gkoutos, Georgios V, Goettsch, Wim, Hemingway, Harry, Ingvar, Martin, Jonas, Adrian, Kazmierski, Robert, Løgstrup, Susanne, Lumbers, R Thomas, Lüscher, Thomas F, McGreavy, Paul, Piña, Ileana L, Roessig, Lothar, Steinbeisser, Carl, Sundgren, Mats, Tyl, Benoît, Thiel, Ghislaine van, Bochove, Kees van, Vardas, Panos E, Villanueva, Tiago, Vrana, Marilena, Weber, Wim, Weidinger, Franz, Windecker, Stephan, Wood, Angela, and Grobbee, Diederick E

Abstract

Big data is important to new developments in global clinical science that aim to improve the lives of patients. Technological advances have led to the regular use of structured electronic health-care records with the potential to address key deficits in clinical evidence that could improve patient care. The COVID-19 pandemic has shown this potential in big data and related analytics but has also revealed important limitations. Data verification, data validation, data privacy, and a mandate from the public to conduct research are important challenges to effective use of routine health-care data. The European Society of Cardiology and the BigData@Heart consortium have brought together a range of international stakeholders, including representation from patients, clinicians, scientists, regulators, journal editors, and industry members. In this Review, we propose the CODE-EHR minimum standards framework to be used by researchers and clinicians to improve the design of studies and enhance transparency of study methods. The CODE-EHR framework aims to develop robust and effective utilisation of health-care data for research purposes.

Published
2022
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