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基于2021年欧洲心脏病学会指南对新型基于网络的应用程序HUMTELEMED进行心血管风险综合评估的验证

Validation of the Novel Web-Based Application HUMTELEMED for a Comprehensive Assessment of Cardiovascular Risk Based on the 2021 European Society of Cardiology Guidelines.

作者信息

Landolfo Matteo, Spannella Francesco, Gezzi Alessandro, Giulietti Federico, Sabbatini Lucia, Bari Isabella, Alessandroni Romina, Di Agostini Angelica, Turri Paolo, Alborino Francesco, Scoppolini Massini Lorenzo, Sarzani Riccardo

机构信息

Internal Medicine and Geriatrics, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Nazionale di Ricovero e Cura per gli Anziani (INRCA), 60127 Ancona, Italy.

Department of Clinical and Molecular Sciences (DISCLIMO), Centre of Obesity, University "Politecnica delle Marche", 60127 Ancona, Italy.

出版信息

J Clin Med. 2024 Apr 16;13(8):2295. doi: 10.3390/jcm13082295.

Abstract

SCORE2/SCORE2-OP cardiovascular risk (CVR) charts and online calculators do not apply to patients with comorbidities, target organ damage, or atherosclerotic cardiovascular disease, for whom the assessment relies on the conventional consultation of the 2021 ESC guidelines (qualitative approach). To simplify the CVR evaluation, we developed an integrated multi-language and free-to-use web application. This study assessed the agreement between the conventional method versus our web app. A cross-sectional study was carried out on 1306 consecutive patients aged 40+ years referred to our center for the diagnosis and management of hypertension and dyslipidemia. Two double-blind operators performed the CVR assessment and classified each patient into low-moderate-, high-, and very-high-risk categories by using the conventional method (SCORE2/SCORE2-OP charts and consultation of the 2021 ESC guidelines) and the web app. The Kappa statistics were used to compare the two methods. : The mean age was 60.3 ± 11.9 years, with male prevalence (51.4%). Patients in primary prevention were 77.0%. According to the SCORE2/SCORE2-OP charts and 2021 ESC guideline consultation, the CVR was low-moderate in 18.6% (n° 243), high in 36.8% (n° 480), and very high in 44.6% (n° 583). According to the web app, individual CVR was low-moderate in 19.5% (n° 255), high in 35.4% (n° 462), and very high in 45.1% (n° 589). The two methods strongly agreed (Kappa = 0.960, < 0.001), with a 97.5% concordance. : our application has excellent reliability in a broad "real life" population and may help non-expert users and busy clinicians to assess individual CVR appropriately, representing a free-to-use, simple, time-sparing and widely available alternative to the conventional CVR evaluation using SCORE2/SCORE2-OP and 2021 ESC guideline charts.

摘要

SCORE2/SCORE2-OP心血管风险(CVR)图表和在线计算器不适用于患有合并症、靶器官损害或动脉粥样硬化性心血管疾病的患者,对于这些患者,评估依赖于2021年欧洲心脏病学会(ESC)指南的常规会诊(定性方法)。为简化CVR评估,我们开发了一个集成的多语言且免费使用的网络应用程序。本研究评估了传统方法与我们的网络应用程序之间的一致性。对连续1306例年龄在40岁及以上因高血压和血脂异常转诊至我们中心进行诊断和管理的患者进行了一项横断面研究。两名双盲操作人员进行CVR评估,并使用传统方法(SCORE2/SCORE2-OP图表和2021年ESC指南会诊)和网络应用程序将每位患者分为低-中度、高和极高风险类别。使用Kappa统计量比较这两种方法。:平均年龄为60.3±11.9岁,男性患病率为(51.4%)。一级预防患者占77.0%。根据SCORE2/SCORE2-OP图表和2021年ESC指南会诊,CVR为低-中度的占18.6%(243例),高的占36.8%(480例),极高的占44.6%(583例)。根据网络应用程序,个体CVR为低-中度的占19.5%(255例),高的占35.4%(462例),极高的占45.1%(589例)。两种方法高度一致(Kappa = 0.960,<0.001),一致性为97.5%。:我们的应用程序在广泛的“现实生活”人群中具有出色的可靠性,可能有助于非专业用户和忙碌的临床医生适当地评估个体CVR,是使用SCORE2/SCORE2-OP和2021年ESC指南图表进行传统CVR评估的一种免费、简单、省时且广泛可用的替代方法。

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