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Patient-reported data match comprehensive HF assessment tools
12 March 2010
MedWire News: Using only the patient-reported elements of heart failure (HF) risk scoring tools does not appear to alter their accuracy, analysis of data from the Atherosclerosis Risk in Communities (ARIC) study has shown.
Outlining the background to their study, Christy Avery (University of North Carolina, Chapel Hill, USA) and co-workers note that “the need for accurate and standardized HF classification criteria prompted the development of several scoring systems including Framingham, Gothenburg, NHANES-I, and Boston.”
Most scoring tools use the same elements, asking questions of HF signs, symptoms, and clinical indices. Symptom scores in particular often rely on patient-reported information; however, few studies have looked specifically at the value of patient-reported heart failure data as separate from scoring tools as a whole.
Accordingly, Avery and team looked for links between self-reported items from the Gothenburg tool and the risk for hospitalization over a period of almost 15 years in 15,430 Caucasian and African–American patients involved in the ARIC study.
“The Gothenburg score is derived from cardiac signs and symptoms, pulmonary signs and symptoms, and therapies for HF,” the investigators explain.
“The criteria were validated in several studies and shown to have a sensitivity of 83.5 and a specificity of 80.9 for classifying HF in a random sample of health care recipients,” the investigators add.
As reported in the European Journal of Heart Failure, self-reported Gothenburg scores gave very similar estimates of HF risk as were gained when using the complete Gothenburg tool.
Self-reported Gothenburg scores also significantly and independently predicted the risk for hospitalization for HF, an association that was not significantly altered by the age or sex of patients.
Summarizing, the authors say that their findings highlight the usefulness of abbreviated and simplified forms of HF risk assessment tools that rely solely on patient-reported data.
The researchers concede that their study is limited because few of the patients included had received treatment with what would now be considered standard therapies, and add that questions about the use of treatment such as beta blockers and ACE inhibitors should be included in future validation studies.
Nevertheless, “the self-reported score could be applied as a screening tool in resource-limited settings without compromising accuracy,” conclude the authors, adding that “the potential impact of these results therefore warrants their prompt replication in other populations.”
