Model performance: comparison of PAH detection approaches
| Approach | RHC referral rate, % (positive detection assessments/all patients) | Overall missed PAH diagnoses, % (false negatives) | Overall sensitivity, % | Overall specificity, % | Overall PPV, % | Overall NPV, % |
|---|---|---|---|---|---|---|
| Primary analysis | ||||||
| DETECT algorithm N=319 | 62 | 4 | 96 | 48 | 35 | 98 |
| Other analyses | ||||||
| DETECT algorithm with 65% specificity at Step 2 N=319 | 41 | 15 | 85 | 72 | 47 | 94 |
| ESC/ERS guidelines*1 N=371 | 40 | 29 | 71 | 69 | 40 | 89 |
*Evaluated on a subset of patients (N=371) with available data for the variables defined in the guideline, using the following criteria for RHC referral1: (a) Tricuspid regurgitant jet velocity >3.4 m/s; or (b) Tricuspid regurgitant jet velocity >2.8–≤3.4 m/s AND symptomatic (defined as at least one of the following DETECT parameters: current anginal pain, current syncope/near syncope, current dyspnoea, presence of peripheral oedema); or (c) Tricuspid regurgitant jet velocity ≤2.8 m/s AND symptomatic (defined as above) AND presence of additional echocardiography variables suggestive of pulmonary hypertension (defined as right atrium area >16 cm2 and/or ratio of right ventricular diameter/left ventricular end diastolic diameter >0.8).
ESC/ERS, European Society of Cardiology/European Respiratory Society; NPV, negative predictive value; PAH, pulmonary arterial hypertension; PPV, positive predictive value (confirmed PAH out of all RHC referrals); RHC, right heart catheterisation.