Evidence map›Paper›PMID 33537406›Full record

ArticleInternational journal of cardiology. Heart & vasculature2021

Update and, internal and temporal-validation of the FRANCE-2 and ACC-TAVI early-mortality prediction models for Transcatheter Aortic Valve Implantation (TAVI) using data from the Netherlands heart registration (NHR).

Hatem Al-Farra, Bas A J M de Mol, Anita C J Ravelli, W J P P Ter Burg, Saskia Houterman, José P S Henriques, Ameen Abu-Hanna, M M Vis, J Vos, L Timmers and 11 more

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In one paragraph

Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Hatem Al-FarraDepartment of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Bas A J M de MolHeart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Anita C J RavelliDepartment of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
W J P P Ter BurgDepartment of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Saskia HoutermanNetherlands Heart Registration, Utrecht, the Netherlands.
José P S HenriquesHeart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Ameen Abu-HannaDepartment of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
M M VisHeart Center, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
J VosAmphia Hospital, the Netherlands.
L TimmersSt. Antonius Hospital, the Netherlands.
W A L ToninoCatharina Hospital, the Netherlands.
C E SchotborghHaga Hospital, the Netherlands.
V RoolvinkIsala, the Netherlands.
F PortaLeeuwarden Medical Center, the Netherlands.
M G StoelMedisch Spectrum Twente, the Netherlands.
S KatsMaastricht University Medical Center, the Netherlands.
G AmorosoOnze Lieve Vrouwe Gasthuis, the Netherlands.
H W van der WerfUniversity Medical Center Groningen, the Netherlands.
P R StellaUniversity Medical Center Utrecht, the Netherlands.
P de JaegereErasmus University Medical Center, the Netherlands.
NHR THI Registration Committee

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe predictive performance of the models FRANCE-2 and ACC-TAVI for early-mortality after Transcatheter Aortic Valve Implantation (TAVI) can decline over time and can be enhanced by updating them on new populations. We aim to update and internally and temporally validate these models using a recent TAVI-cohort from the Netherlands Heart Registration (NHR).

methodsWe used data of TAVI-patients treated in 2013-2017. For each original-model, the best update-method (model-intercept, model-recalibration, or model-revision) was selected by a closed-testing procedure. We internally validated both updated models with 1000 bootstrap samples. We also updated the models on the 2013-2016 dataset and temporally validated them on the 2017-dataset. Performance measures were the Area-Under ROC-curve (AU-ROC), Brier-score, and calibration graphs.

resultsWe included 6177 TAVI-patients, with 4.5% observed early-mortality. The selected update-method for FRANCE-2 was model-intercept-update. Internal validation showed an AU-ROC of 0.63 (95%CI 0.62-0.66) and Brier-score of 0.04 (0.04-0.05). Calibration graphs show that it overestimates early-mortality. In temporal-validation, the AU-ROC was 0.61 (0.53-0.67).The selected update-method for ACC-TAVI was model-revision. In internal-validation, the AU-ROC was 0.63 (0.63-0.66) and Brier-score was 0.04 (0.04-0.05). The updated ACC-TAVI calibrates well up to a probability of 20%, and subsequently underestimates early-mortality. In temporal-validation the AU-ROC was 0.65 (0.58-0.72).

conclusionInternal-validation of the updated models FRANCE-2 and ACC-TAVI with data from the NHR demonstrated improved performance, which was better than in external-validation studies and comparable to the original studies. In temporal-validation, ACC-TAVI outperformed FRANCE-2 because it suffered less from changes over time.

Indexed as

ACC-TAVI (ACC TVT), American College of Cardiology Transcatheter Valve TherapyAmsterdam UMC, Amsterdam University Medical Center - location AMC (Academic Medical Center)AU-PRC, Area Under the Precision-Recall CurveAU-ROC, Area Under the Receiver Operating-Characteristic CurveBSS, Brier-skill scoreClosed-testing procedureEuroSCORE, European System for Cardiac Operative Risk EvaluationExternal ValidationFRANCE-2, French Aortic National CoreValve and Edwards [15]LVEF, Left Ventricular Ejection FractionModel recalibrationModel updatingMPM, Mortality Prediction ModelsNHR, Netherlands Heart Registration (“Nederlandse Hart Registratie in Dutch”)NYHA, New York Heart AssociationPrediction modelsSAVR, Surgical Aortic Valve ReplacementTAVI (TAVR), Transcatheter Aortic Valve Implantation (Replacement)Transcatheter Aortic Valve Implantation (TAVI)

Identifiers

PMID33537406
PMCPMC7843396

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.