Applying diagnosis support systems in electronic health records to identify wild-type transthyretin amyloid cardiomyopathy risk

Future Cardiol. 2022 May;18(5):367-376. doi: 10.2217/fca-2021-0122. Epub 2022 Jan 31.

Abstract

Aim: Wild-type transthyretin amyloid cardiomyopathy (ATTRwt-CM) is frequently misdiagnosed, and delayed diagnosis is associated with substantial morbidity and mortality. At three large academic medical centers, combinations of phenotypic features were implemented in electronic health record (EHR) systems to identify patients with heart failure at risk for ATTRwt-CM. Methods: Phenotypes/phenotype combinations were selected based on strength of correlation with ATTRwt-CM versus non-amyloid heart failure; different clinical decision support and reporting approaches and data sources were evaluated on Cerner and Epic EHR platforms. Results: Multiple approaches/sources showed potential usefulness for incorporating predictive analytics into the EHR to identify at-risk patients. Conclusion: These preliminary findings may guide other medical centers in building and implementing similar systems to improve recognition of ATTRwt-CM in patients with heart failure.

Keywords: amyloidosis; artificial intelligence; cardiomyopathy; diagnosis; electronic health record; heart failure; machine learning; screening; transthyretin.

MeSH terms

  • Amyloid Neuropathies, Familial* / diagnosis
  • Cardiomyopathies* / diagnosis
  • Electronic Health Records
  • Heart Failure* / diagnosis
  • Humans
  • Prealbumin / genetics

Substances

  • Prealbumin

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