Fahey et al developed a clinical prediction rule for diagnosis of left ventricular systolic dysfunction (LVSD) in primary care. The authors are from the University of Dundee and the Royal College of Surgeons of Ireland.
Purpose: to identify a patient with left ventricular systolic dysfunction in general practice using the physical exam and an ECG.
Parameters:
(1) male gender
(2) past myocardial infarction
(3) orthopnea
(4) raised jugular venous pressure
(5) ECG
Gender
Past MI
Orthopnea
Raised JVP
Normal ECG
Abnormal ECG
F
N
N
N
0
0.06
F
N
N
Y
0.03
0.38
F
N
Y
N
0.02
0.28
F
N
Y
Y
0.14
0.77
F
Y
N
N
0.01
0.23
F
Y
N
Y
0.11
0.72
F
Y
Y
N
0.08
0.63
F
Y
Y
Y
0.42
0.94
M
N
N
N
0.01
0.13
M
N
N
Y
0.06
0.57
M
N
Y
N
0.04
0.46
M
N
Y
Y
0.26
0.88
M
Y
N
N
0.03
0.40
M
Y
N
Y
0.22
0.85
M
Y
Y
N
0.15
0.79
M
Y
Y
Y
0.61
0.97
Performance:
• The model under-predicted LVSD in the validation cohort. This was ascribed to differences in the risk-factor profiles between the derivation and validation cohorts.
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