Algorithm Assessed for Early Diagnosis of Pulmonary Arterial Hypertension in Systemic Sclerosis



Title: High sensitivity and negative predictive value of the DETECT algorithm for an early diagnosis of pulmonary arterial hypertension in systemic sclerosis: application in a single center

Guillén-Del Castillo, A et al.


 

What You Need to Know:

The DETECT algorithm, which was recently published to aid in the screening of pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc), was also found be an effective tool in assisting in the early diagnosis of “borderline” median pulmonary arterial pressure (mPAP) or pulmonary hypertension (PH) due to its high sensitivity and negative predictive value, as well as its low rate of missed diagnoses.

Trial Design:

  • Multicenter study assessed the value of the DETECT algorithm, compared it to the European Society of Cardiology/European Respiratory Society (ESC/ERS) 2009 guidelines, and evaluated its ability to screen for PAH, mPAP ≥21 mmHg, and PH
  • 83 patients “fulfilling LeRoy's systemic sclerosis diagnostic criteria with at least right heart catheterization were studied retrospectively”
  • Study obtained clinical data, serological biomarkers, and echocardiographic and hemodynamic qualities

Key Outcomes:

  • 35 patients with PAH and 28 patients without PAH met criteria for analysis via the DETECT algorithm
  • 27% of patients were considered functional class III/IV
  • Sensitivity, specificity, positive predictive value, and negative predictive value were found to be 100%, 42.9%, 68.6%, and 100%, respectively, when utilizing the DETECT algorithm
  • Sensitivity, specificity, positive predictive value, and negative predictive value were found to be 91.4%, 85.7%, 88.9%, and 89.3%, respectively, when utilizing the ESC/ERS guidelines
  • Missed diagnoses of PAH: zero using DETECT vs 3 missed diagnoses when using ESC/ERS guidelines
  • “The DETECT algorithm also showed greater sensitivity and negative predictive value to identify patients with mPAP ≥21 mmHg or with any type of PH”