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White RT, Sankey K, Anderson JR, Bos AJ, Aragon KG, Martinez-Nava DD, Rubio AM, Turner RM, Ray GM. Community Pharmacists Identification of Gaps in Care - Statin Utilization for Primary Prevention. J Pharm Pract 2024:8971900241262362. [PMID: 38914018 DOI: 10.1177/08971900241262362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
Background: Statins are a highly effective lipid-lowering therapy associated with significant reductions in atherosclerotic cardiovascular disease (ASCVD) events and death. Despite these benefits, statins are underutilized. Pharmacist-led interventions to increase statin prescribing are effective. To our knowledge, no prior studies implemented a comprehensive cardiovascular risk assessment utilizing point-of-care (POC) testing in community pharmacies. Objectives: The primary objective was to determine if community pharmacists can be utilized to identify gaps in care regarding appropriate use of statin therapy for prevention of ASCVD events in HPSAs. Secondary objectives were to assess public interest in ASCVD risk assessment and statin prescribing by the pharmacist, and to identify factors associated with statin gaps in care. Methods: A cross-sectional study was conducted at three independent community pharmacies. Participants were identified based on age and medication history and were scheduled at their pharmacy to receive a comprehensive ASCVD risk screening consisting of POC measurement of a complete lipid panel, blood glucose or A1C, and blood pressure. Participants were informed of their statin candidacy at the screening. Participants completed a survey regarding perceptions of the services provided and opinions of statin prescribing by pharmacists. Results: Of the 57 participants, 43 (75.4%) were possible statin candidates. Most indicated trusting their pharmacist to prescribe a cholesterol-lowering medication and felt insurance should pay for these screenings. Conclusion: ASCVD risk assessment conducted within the community pharmacy setting for can be utilized to identify treatment gaps in status use. Participants indicated trusting pharmacists to provide this service and found the service valuable.
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Affiliation(s)
- Raechel T White
- PGY2 Ambulatory Care Resident, University of New Mexico College of Pharmacy, Albuquerque NM, USA
| | - Kjersten Sankey
- PGY2 Ambulatory Care Resident, University of New Mexico College of Pharmacy, Albuquerque NM, USA
| | - Joe R Anderson
- Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Alexander J Bos
- Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Kelsea Gallegos Aragon
- Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | | | - Annajita M Rubio
- University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Robyn M Turner
- University of New Mexico College of Pharmacy, Albuquerque, NM, USA
| | - Gretchen M Ray
- Department of Pharmacy Practice and Administrative Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM, USA
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Benitez X, Aragon K, Jakeman B, Bachyrycz A, Iandiorio M, Meliniotis A, Shah M, Stever E, Herman A. Patient perspectives and needs regarding contraception in female patients with HIV: A qualitative study. J Am Pharm Assoc (2003) 2024; 64:307-313. [PMID: 37952846 DOI: 10.1016/j.japh.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Women with human immunodeficiency virus (HIV) are at risk of unintended pregnancy and may experience barriers to accessing contraception such as social stigma, concern for drug-drug interactions with HIV regimens, cost, and access to care. As pharmacist prescriptive authority for contraception becomes more prevalent, pharmacists may play a role in expanding access to contraception for women with HIV. Little is known about perspectives in this population regarding pharmacists prescribing contraception. OBJECTIVES The objective of our study was to explore participants' experiences with contraception and childbearing, identify barriers to receiving contraception and unmet needs for contraceptive services, and explore perspectives on pharmacists prescribing contraception among women with HIV receiving care at a specialty HIV clinic. METHODS This qualitative study used semistructured phone interviews with female patients receiving care at the University of New Mexico Truman Health Services in Albuquerque, New Mexico (NM). Interviews were transcribed verbatim and analyzed by 2 independent coders using Dedoose software. RESULTS Contraception use was high in our population, with 75% of participants reporting a current contraceptive method. Among our population, participants were supportive of pharmacists prescribing contraception. Participants appreciated that pharmacies were accessible and convenient and that pharmacists are well trained and able to manage drug-drug interactions. Participants expressed a preference for pharmacists to explain all available contraceptive options and to have a thorough understanding of their medical history and medications. Participants expressed concern about privacy and disclosure of their HIV status when receiving contraception from a pharmacist. CONCLUSION Among our population of women with HIV receiving care at a specialty clinic in NM, participants were supportive of pharmacists prescribing contraception. Pharmacists should consider the preferences of this population when prescribing contraception. Further research is warranted in additional populations of women with HIV to further explore unique perspectives among non-English speaking patients and those who do not receive care at specialty clinics.
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Norman K, Cassim S, Papa V, Te-Karu L, Clark P, Mullins H, Chepulis L. "Prescribing for the whole person": A qualitative study exploring prescribing pharmacist views on type 2 diabetes management in New Zealand. BMC Health Serv Res 2023; 23:1058. [PMID: 37794403 PMCID: PMC10552232 DOI: 10.1186/s12913-023-09877-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 08/04/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Pharmacist prescribers have comprehensive pharmacotherapy knowledge that can be useful for management of complex health conditions such as type 2 diabetes, yet the number of pharmacist prescribers working in New Zealand primary care is low. AIM To explore the experiences of pharmacist prescribers in supporting type 2 diabetes management in New Zealand primary care. METHODS Qualitative research design using semi-structured interviews with six pharmacist prescribers working in NZ primary care. Thematic analysis guided this study and themes were finalised with the wider research team. RESULTS Three major themes were identified: team approach, health inequity and the role of a pharmacist prescriber. This study found that pharmacist prescribers may improve health equity by providing advanced pharmacotherapy knowledge within a wider primary care team to support complex patient needs and understanding the wider social determinants of health that impact effective diabetes management. Participants reportedly had more time to spend with patients (than GPs or nurses) and could also contribute to improving health outcomes by directly educating and empowering patients. CONCLUSION The views of pharmacist prescribers have seldom been explored and this study suggests that their role may be under-utilised in primary care. In particular, pharmacist prescribers can provide specialist prescribing (and often mobile) care, and may contribute to improving health outcomes and reducing inequity when used as part of a multi-disciplinary team.
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Affiliation(s)
- Kimberley Norman
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Private Bag 3216, Hamilton, New Zealand
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Shemana Cassim
- Te Kura Hinengaro Tangata School of Psychology, Massey University, Auckland, New Zealand
| | - Valentina Papa
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Private Bag 3216, Hamilton, New Zealand
| | - Leanne Te-Karu
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Penny Clark
- Northcare Medical Centre, Hamilton, New Zealand
| | - Hilde Mullins
- Department of Nursing, Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Lynne Chepulis
- Medical Research Centre, Te Huataki Waiora School of Health, University of Waikato, Private Bag 3216, Hamilton, New Zealand.
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Mehta A, Dixon DL, Saeed A, Kelly MS, Gulati M, Shapiro MD, Sperling LS, Virani SS. With Current Safety and Efficacy Data, Should Statins Be Made Available as Nonprescription Over-the-Counter Drugs? Curr Cardiol Rep 2023; 25:423-430. [PMID: 36971960 DOI: 10.1007/s11886-023-01861-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/16/2023]
Abstract
PURPOSE OF REVIEW Statins inhibit the enzyme 3-hydroxy-3-methylglutaryl-coenzyme A reductase in the liver and reduce atherosclerotic cardiovascular disease (ASCVD) risk by enhancing low-density lipoprotein (LDL) clearance from the circulation. In this review, we discuss their efficacy, safety, and real-world utilization to make a case for reclassifying statins as nonprescription over-the-counter drugs to improve access and availability with the overarching goal of increasing statin utilization in patients most likely to benefit from this class of therapy. RECENT FINDINGS Statin efficacy for reducing risk in primary and secondary ASCVD prevention populations as well as their safety and tolerability has been thoroughly investigated in large-scale clinical trials over the past 3 decades. Despite the overwhelming scientific evidence, statins are underutilized even among those at the highest ASCVD risk. We propose a nuanced approach to use statins as nonprescription drugs that leverages a multi-disciplinary clinical model. It integrates lessons learned from experiences outside the USA with a proposed Food and Drug Administration rule change that allows nonprescription drug products with an additional condition for nonprescription use.
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Affiliation(s)
- Anurag Mehta
- VCU Health Pauley Heart Center and Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Dave L Dixon
- VCU Health Pauley Heart Center and Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, VA, USA
| | - Anum Saeed
- Heart and Vascular Institute, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Michael S Kelly
- Thomas Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, USA
| | - Martha Gulati
- Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Smidt Heart Institute, Los Angeles, CA, USA
| | - Michael D Shapiro
- Center for Prevention of Cardiovascular Disease, Section On Cardiovascular Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Salim S Virani
- Department of Medicine, The Aga Khan University, Karachi, Pakistan.
- Section of Cardiology, Department of Internal Medicine, Baylor College of Medicine, Houston, USA.
- Michael E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Boulevard, Houston, TX, 77030, USA.
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Elnour AA, Raja NS, Abdi F, Mostafiz F, Elmubarak RI, Khalil AM, Hait KA, Alqahtani MM, Dabbagh N, Abdulnasser Z, Albek D, Amer A, Damook NOA, Shayeb A, Alblooshi S, Samir M, Hajal AA, Barakani NA, Balbahaith R, Mazrouie HA, Ali RA. Protocol for systematic review and meta-analysis of randomized controlled trials, cost-benefit analysis and interrupted time-series interventions on pharmacist's prescribing. Pharm Pract (Granada) 2022; 20:2713. [PMID: 36733516 PMCID: PMC9851817 DOI: 10.18549/pharmpract.2022.3.2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/11/2022] [Indexed: 02/05/2023] Open
Abstract
Background Shortening the process of prescribing via permitting the pharmacist to select the most appropriate pharmaceuticals for each particular patient may provide great opportunities for pharmacists to develop suitable pharmaceutical care plan, monitor and follow up prescribed medications, communicate and consult physicians for more confirmations. Objective The objective of the current protocol for the systematic review and meta-analysis of pharmacists prescribing interventions was to explore, investigate the evidence, assess and compare PICO in patients with medical conditions (population), receiving pharmacist's prescribing care services (interventions) versus non-pharmacist's prescribing (comparators), and identify how it will impact the clinical, humanistic, and economic patient's outcomes (outcomes). Methods The necessary elements of PRISMA will be strictly followed to report the systematic review. The meta-analysis will be reported in line with the Cochrane guidelines for synthesis of trials and all forms will be based on quality measures as per the validated Cochrane templates. We will present the results of the systematic review and the meta-analysis based on PICO comparison between the included trials. Results We have identified four models of pharmacist prescribing interventions (independent, dependent [collaborative], supplementary, and emergency prescribing). The results will contain a systematic critical evaluation of the included trials in terms of the sample number of the population (characteristics), the type of interventions and the comparators, and the main outcome measures. Conclusion This protocol will report the evidence and explore the magnitude of impact of pharmacist prescribing interventions, on clinical, humanistic, and economic outcomes. .
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Affiliation(s)
- Asim Ahmed Elnour
- PhD, MSc. Program of Clinical Pharmacy, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates. AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates. ;
| | - Nadia Sarfaraz Raja
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Fatemeh Abdi
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Fariha Mostafiz
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Razan Isam Elmubarak
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Alaa Mohsen Khalil
- Intern student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi- United Arab Emirates.
| | - Khawla Abou Hait
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Mariam Mohamed Alqahtani
- Intern student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Nour Dabbagh
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Zainab Abdulnasser
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Danah Albek
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Abdelfattah Amer
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Nosayba Othman Al Damook
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Aya Shayeb
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Sara Alblooshi
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Mohammed Samir
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Abdallah Abou Hajal
- Post-graduate MSc student, BSc, Pharmaceutical Sciences, College of Pharmacy, Al Ain University (AAU), Abu Dhabi campus, Abu Dhabi- United Arab Emirates. AAU Health and Biomedical Research Centre, Al Ain University, Abu Dhabi, UAE.
| | - Nora Al Barakani
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Rahf Balbahaith
- Fourth year student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Hamda Al Mazrouie
- Intern student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
| | - Rahaf Ahmed Ali
- Intern student, College of Pharmacy, Al Ain University, Abu Dhabi campus, Abu Dhabi-United Arab Emirates.
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Elkomos M, Jahromi R, Kelly MS. Pharmacist-Led Programs to Increase Statin Prescribing: A Narrative Review of the Literature. PHARMACY 2022; 10:pharmacy10010013. [PMID: 35076632 PMCID: PMC8788429 DOI: 10.3390/pharmacy10010013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 02/01/2023] Open
Abstract
Statins are lipid-lowing medications shown to reduce cardiovascular events and are recommended for specific patient populations at elevated risk of atherosclerotic cardiovascular disease (ASCVD). Despite the demonstrated efficacy of statins for reducing ASCVD risk, and guidance on which populations should receive statin therapy, a substantial portion of eligible patients are not prescribed statin therapy. Pharmacists have attempted to increase the number of eligible patients receiving appropriate statin therapy through a variety of interventions and across several clinical settings. In this article, we highlight multiple studies evaluating the effectiveness of pharmacist-led interventions to improve statin use. A total of seven studies were selected for this narrative review, demonstrating the effectiveness and barriers of different statin-initiation programs delivered by pharmacists to increase statin use in eligible patients. Among the interventions assessed, a combination of provider communicating and statin prescribing through collaborative drug therapy management (CDTM) appear to the be the most useful at increasing statin use. Pharmacists can significantly improve statin use rates among eligible patients through multiple intervention types and across different clinical settings. Further studies should evaluate continued statin adherence and clinical outcomes among patients served by pharmacists.
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Affiliation(s)
- Mary Elkomos
- Chapman University School of Pharmacy, Irvine, CA 92618, USA; (M.E.); (R.J.)
| | - Raha Jahromi
- Chapman University School of Pharmacy, Irvine, CA 92618, USA; (M.E.); (R.J.)
| | - Michael S. Kelly
- Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, CA 92618, USA
- Correspondence:
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Adams AJ, Frost TP. Pathways to pharmacist prescriptive authority: Do decentralized models for expanded prescribing work? Res Social Adm Pharm 2021; 18:2695-2699. [PMID: 34321187 DOI: 10.1016/j.sapharm.2021.07.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 11/18/2022]
Abstract
Scope of practice decisions, such as granting pharmacists independent prescriptive authority, are governed at the state level and are often contentious debates. Five states - Florida (FL), New Mexico (NM), Colorado (CO), Idaho (ID), and Oregon (OR) -- have created structures that can theoretically expand independent prescriptive authority through decentralized approaches rather than needing the legislature to approve each drug that pharmacists may prescribe. These approaches have the potential advantage of allowing the states to expand independent pharmacist prescriptive authority to address public health needs more quickly. Four distinct models have been identified from most to least restrictive in practice: 1) medical veto; 2) interdisciplinary committee; 3) board of pharmacy; and 4) pharmacist-determined. These models have generally focused on postdiagnostic and preventive care by pharmacists. In terms of enabling broad pharmacist prescribing, only two of these models have demonstrated success: board of pharmacy and pharmacist-determined. Pharmacy and public health stakeholders considering similar legislation in their own states should consider the success of these decentralized models prior to enacting legislation.
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Affiliation(s)
- Alex J Adams
- Idaho Division of Financial Management, 4537 N Molly Way, Meridian, ID, 83646, USA.
| | - Timothy P Frost
- Idaho Division of Occupational and Professional Licenses, Boise, ID, 83701, USA
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Pollard JD, Haq KT, Lutz KJ, Rogovoy NM, Paternostro KA, Soliman EZ, Maher J, Lima JAC, Musani SK, Tereshchenko LG. Electrocardiogram machine learning for detection of cardiovascular disease in African Americans: the Jackson Heart Study. EUROPEAN HEART JOURNAL. DIGITAL HEALTH 2021; 2:137-151. [PMID: 34048510 PMCID: PMC8139412 DOI: 10.1093/ehjdh/ztab003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 12/10/2020] [Accepted: 01/12/2021] [Indexed: 01/31/2023]
Abstract
AIMS Almost half of African American (AA) men and women have cardiovascular disease (CVD). Detection of prevalent CVD in community settings would facilitate secondary prevention of CVD. We sought to develop a tool for automated CVD detection. METHODS AND RESULTS Participants from the Jackson Heart Study (JHS) with analysable electrocardiograms (ECGs) (n=3679; age, 6212 years; 36% men) were included. Vectorcardiographic (VCG) metrics QRS, T, and spatial ventricular gradient vectors magnitude and direction, and traditional ECG metrics were measured on 12-lead ECG. Random forests, convolutional neural network (CNN), lasso, adaptive lasso, plugin lasso, elastic net, ridge, and logistic regression models were developed in 80% and validated in 20% samples. We compared models with demographic, clinical, and VCG input (43 predictors) and those after the addition of ECG metrics (695 predictors). Prevalent CVD was diagnosed in 411 out of 3679 participants (11.2%). Machine learning models detected CVD with the area under the receiver operator curve (ROC AUC) 0.690.74. There was no difference in CVD detection accuracy between models with VCG and VCG + ECG input. Models with VCG input were better calibrated than models with ECG input. Plugin-based lasso model consisting of only two predictors (age and peak QRS-T angle) detected CVD with AUC 0.687 [95% confidence interval (CI) 0.6250.749], which was similar (P=0.394) to the CNN (0.660; 95% CI 0.5970.722) and better (P<0.0001) than random forests (0.512; 95% CI 0.4930.530). CONCLUSIONS Simple model (age and QRS-T angle) can be used for prevalent CVD detection in limited-resources community settings, which opens an avenue for secondary prevention of CVD in underserved communities.
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Affiliation(s)
- James D Pollard
- University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA
| | - Kazi T Haq
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA
| | - Katherine J Lutz
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA
| | - Nichole M Rogovoy
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA
| | - Kevin A Paternostro
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA
| | - Elsayed Z Soliman
- Division of Public Health Sciences and Department of Medicine, Cardiology Section, Epidemiological Cardiology Research Center, Wake Forest School of Medicine, 475 Vine St, Winston-Salem, NC 27101, USA
| | - Joseph Maher
- University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA
| | - João A C Lima
- Cardiovascular Division, Department of Medicine, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
| | - Solomon K Musani
- University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA
| | - Larisa G Tereshchenko
- Department of Medicine, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, UHN62, Portland, OR 97239, USA
- Cardiovascular Division, Department of Medicine, Johns Hopkins School of Medicine, 733 N Broadway, Baltimore, MD 21205, USA
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