Trial reportEuropean journal of epidemiology2025
Identification of individuals who benefit from omega-3 fatty acid supplementation to prevent coronary heart disease: a machine-learning analysis of the VITAL.
Trial report in European journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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.
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Authors and funding
6 authors.
Funding
Abstract
Randomized controlled trials (RCTs) have demonstrated benefits of marine omega-3 polyunsaturated fatty acids (omega-3 FA) supplementation for the prevention of coronary heart disease (CHD). However, it has not been clear which individuals benefit the most from supplementation. We sought to develop an omega-3 effect score to stratify individuals according to their expected benefit from supplementation. Among the 25,871 randomized participants without a history of cardiovascular disease in the VITamin D and OmegA-3 TriaL (VITAL), we applied machine-learning (ML) approaches to predict individual treatment effect of omega-3 FA supplementation on 5-year CHD risk using 11 covariates pre-specified in the VITAL protocol. An omega-3 effect score was developed such that each covariate contributed linearly. ML algorithms effectively stratified participants by their expected benefit according to individual factors; for example, there was 1.21% absolute CHD risk reduction in the top tertile of the expected benefit, compared with the average effect of 0.47% risk reduction. Baseline diabetes, race, hypertension, sex, and fish intake contributed the most to the omega-3 effect score. Five-year CHD risk was 2.5% among those in the omega-3 arm and 3.2% among those in the placebo arm with omega-3 effect score ≥ 4 (upper 70th percentile), and 1.4% among the omega-3 arm and 1.3% among the placebo arm in those with the score < 4, respectively. The transportability of the score to the National Health and Nutrition Examination Survey (NHANES) data was confirmed. Although testing of the score in a new RCT is warranted, the proposed omega-3 effect score holds promise for guiding decision making for omega-3 FA supplementation in the US primary prevention population.
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