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teleforceyesterday at 10:50 PM5 repliesview on HN

For non-invasive heart disease risk prediction nothing beat ECG, period.

Somehow American Heart Association and its European counterpart are in denial, and still pushing dinasour screening mechanism with very low accuracy for heart disease risk prediction.

The standard risk model for CVD based on PREVENT (US) and SCORE-2 (Europe) like parameters are very poor as reported in the recently published paper on the their accuracy performance by the Swedish team [1]. As all CVD risk stratification with cardiologist review (expert-in-the-loop), the most important accuracy metric is sensivity/recall (avoiding false negative that will escape review) of PREVENT and SCORE-2, 26% and 48%, respectively.

The paper alternative proposal increased the sensitivity to 58% by performing clustering instead of conventional regression models as practiced in the PREVENT and SCORE-2.

These type of models including the latest proposal performed very poorly as indicated by their otherwise excellent and intuitive display of graphical abstract results [1].

[1] Risk stratification for cardiovascular disease: a comparative analysis of cluster analysis and traditional prediction models:

https://academic.oup.com/eurjpc/advance-article/doi/10.1093/...


Replies

zhivotatoday at 4:00 AM

I'm not sure how ECG relates, how would ECG predict heart disease risk? I don't see any evidence of that, it's not even mentioned in the article you linked, which is odd considering the whole approach of clustering is gathering as many risk factors and relevant test results as are available.

nradovtoday at 1:03 AM

There are lots of different types of heart disease. An ECG can be useful for diagnosing some of them but you're overstating the relative value. For many patients, a CT coronary calcium score or CT angiogram may be more valuable in terms of detecting the type of arterial plaques that might require medical management or major lifestyle modifications in order to prevent a heart attack. These are also non-invasive, although they do involve some radiation exposure.

https://www.mayoclinic.org/tests-procedures/heart-scan/about...

https://www.mayoclinic.org/tests-procedures/ct-coronary-angi...

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er4yesterday at 11:49 PM

Get as many scans you can under insurance. Data is king and Claude happens to chew it all pretty well. Apple Health data by itself and family history is enough to make a starter PDF for your cardiologist.

Getting an ECG, EKG, TTE, CAC, carotid duplex US, lipid panel, CMP, TSH, 25-OH Vit D, B12 + folate were what my cardio recommended before appointment #2 on hypertension. Both of us are data guys.

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sscaryterryyesterday at 11:17 PM

How many ECGs can you sell vs how many other snake-oil products? :)

(Edit: This is intended to be sarcastic. I agree 100% with the comment)

(Edit 2: Added the smiley face)

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fatcatsbestcatsyesterday at 11:29 PM

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