Emanuele Di Angelantonio, Lisa Pennells, Magdy Abdelhamid, Victor Aboyans, Riccardo Asteggiano, Jelena Čelutkienė, Diederick E Grobbee, Bernard Iung, Peter Jüni, John William McEvoy, Amina Rakisheva, Xavier Rossello, Frank L J Visseren, Colin Baigent, Eva B Prescott
{"title":"2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations II: diagnostic tests and prediction models.","authors":"Emanuele Di Angelantonio, Lisa Pennells, Magdy Abdelhamid, Victor Aboyans, Riccardo Asteggiano, Jelena Čelutkienė, Diederick E Grobbee, Bernard Iung, Peter Jüni, John William McEvoy, Amina Rakisheva, Xavier Rossello, Frank L J Visseren, Colin Baigent, Eva B Prescott","doi":"10.1093/eurheartj/ehaf016","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf016","url":null,"abstract":"<p><p>The level of evidence (LOE) grading system for European Society of Cardiology (ESC) Clinical Practice Guidelines (CPG) classifies the quality of the evidence supporting a recommendation. However, the current taxonomy does not fully consider the optimal study design necessary to establish evidence for different types of recommendations in ESC guidelines. Therefore, two separate task forces of clinical and methodological experts were appointed by the CPG Committee, with the first tasked with updating the LOE grading system for therapy and prevention and the second responsible for developing a LOE grading system for diagnosis and prediction. This report from the second of these Task Forces develops a new system for diagnostic tests and prediction models which maintains the three-level grading structure to classify the quality of the evidence but introduces new definitions specific for diagnosis and prediction. For diagnostic tests, LOE A represents conclusive evidence of adequate diagnostic ability from at least two high-quality studies. Level of evidence B represents suggestive evidence from one high-quality or at least two moderate-quality studies. Level of evidence C represents preliminary evidence not classified as A or B, including evidence from less than two moderate-quality studies, or from expert consensus. For prediction models, LOE A represents conclusive evidence of adequate predictive ability from at least one high-quality derivation and two or more external validation studies of at least moderate quality. Level of evidence B represents suggestive evidence in one or more derivation studies and one or more external validation studies of at least moderate quality. Level of evidence C represents preliminary evidence not classified as A or B, including evidence from a derivation study of at least moderate quality, but with low quality or no external validation, or a derivation study of low quality.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Jüni, Sotiris Antoniou, Elena Arbelo, Sergio Buccheri, Maja Cikes, Bruno R da Costa, Laurent Fauchier, Chris P Gale, Sigrun Halvorsen, Stefan James, Konstantinos C Koskinas, Dipak Kotecha, Ulf Landmesser, Basil S Lewis, Maja-Lisa Løchen, Jens Cosedis Nielsen, Xavier Rosselló, Ilonca Vaartjes, Eva B Prescott, Colin Baigent
{"title":"2024 Revision of the level of evidence grading system for ESC clinical practice guideline recommendations I: therapy and prevention.","authors":"Peter Jüni, Sotiris Antoniou, Elena Arbelo, Sergio Buccheri, Maja Cikes, Bruno R da Costa, Laurent Fauchier, Chris P Gale, Sigrun Halvorsen, Stefan James, Konstantinos C Koskinas, Dipak Kotecha, Ulf Landmesser, Basil S Lewis, Maja-Lisa Løchen, Jens Cosedis Nielsen, Xavier Rosselló, Ilonca Vaartjes, Eva B Prescott, Colin Baigent","doi":"10.1093/eurheartj/ehaf009","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf009","url":null,"abstract":"<p><p>The level of evidence (LOE) grading system for ESC Clinical Practice Guidelines classifies the quality of the evidence supporting a recommendation. However, the current taxonomy does not fully consider the optimal study design necessary to establish evidence for such recommendations. Therefore, two separate taskforces of clinical and methodological experts were appointed by the Clinical Practice Guidelines Committee, with the first tasked with updating the LOE grading system for therapy and prevention, and the second responsible for developing a LOE grading system for diagnosis and prediction. The updated system for therapy and prevention presented here maintains the three-level grading structure but uses revised definitions. Level of evidence A represents conclusive evidence usually from ≥2 adequately powered randomized controlled trials (RCTs) free from major bias, with substantial evidence against the play of chance when combined in a meta-analysis (e.g. P < .005 for superiority). Additional criteria are specified to define substantial evidence against the play of chance in case of non-inferiority, equivalence, and harm. Level of evidence B is now subdivided into B1 and B2. Level of evidence B1 represents suggestive evidence usually from ≥1 adequately powered RCT free from major bias, or a meta-analysis of such RCTs, with some evidence against the play of chance (e.g. P < .05 for superiority). Level of evidence B2 represents limited evidence from ≥2 adequately powered non-randomized studies with careful control of major sources of bias or from a meta-analysis of small, underpowered RCTs. Level of evidence C represents preliminary evidence from either non-randomized studies without careful control of major sources of bias, a single small, underpowered RCT, or expert consensus.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Better is possible: the fruits of a joint programme in cardiovascular imaging shared by radiologists and cardiologists.","authors":"Marcelo F Di Carli","doi":"10.1093/eurheartj/ehae918","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae918","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Meet the team: new EHJ Editors Rosa Maria Bruno, Mattia Galli, and Mouaz Al-Mallah.","authors":"Judith Ozkan","doi":"10.1093/eurheartj/ehae893","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae893","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Piotr Szymański, Magdalena Lipczyńska, Anna Maria Górska
{"title":"From data to perception: visualizing bias in artificial intelligence-generated images.","authors":"Piotr Szymański, Magdalena Lipczyńska, Anna Maria Górska","doi":"10.1093/eurheartj/ehae850","DOIUrl":"https://doi.org/10.1093/eurheartj/ehae850","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial intelligence to improve cardiovascular population health","authors":"Benjamin Meder, Folkert W Asselbergs, Euan Ashley","doi":"10.1093/eurheartj/ehaf125","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf125","url":null,"abstract":"With the advent of artificial intelligence (AI), novel opportunities arise to revolutionize healthcare delivery and improve population health. This review provides a state-of-the-art overview of recent advancements in AI technologies and their applications in enhancing cardiovascular health at the population level. From predictive analytics to personalized interventions, AI-driven approaches are increasingly being utilized to analyse vast amounts of healthcare data, uncover disease patterns, and optimize resource allocation. Furthermore, AI-enabled technologies such as wearable devices and remote monitoring systems facilitate continuous cardiac monitoring, early detection of diseases, and promise more timely interventions. Additionally, AI-powered systems aid healthcare professionals in clinical decision-making processes, thereby improving accuracy and treatment effectiveness. By using AI systems to augment existing data sources, such as registries and biobanks, completely new research questions can be addressed to identify novel mechanisms and pharmaceutical targets. Despite this remarkable potential of AI in enhancing population health, challenges related to legal issues, data privacy, algorithm bias, and ethical considerations must be addressed to ensure equitable access and improved outcomes for all individuals.","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":"26 1","pages":""},"PeriodicalIF":39.3,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Denisa Muraru, Steffen E Petersen, Victoria Delgado
{"title":"EuroEcho-Imaging 2024: a global forum for echocardiography.","authors":"Denisa Muraru, Steffen E Petersen, Victoria Delgado","doi":"10.1093/eurheartj/ehaf101","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf101","url":null,"abstract":"","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shmaila Saleem-Talib, Crispijn P R Hoevenaars, Nadine Molitor, Vincent J van Driel, Jeroen van der Heijden, Alexander Breitenstein, Harry van Wessel, Mathijs S van Schie, Natasja M S de Groot, Hemanth Ramanna
{"title":"Leadless pacing: a comprehensive review.","authors":"Shmaila Saleem-Talib, Crispijn P R Hoevenaars, Nadine Molitor, Vincent J van Driel, Jeroen van der Heijden, Alexander Breitenstein, Harry van Wessel, Mathijs S van Schie, Natasja M S de Groot, Hemanth Ramanna","doi":"10.1093/eurheartj/ehaf119","DOIUrl":"https://doi.org/10.1093/eurheartj/ehaf119","url":null,"abstract":"<p><p>Over the past decade, leadless pacing has undergone a rapid evolution, resulting in multiple leadless pacemaker (LPM) devices that offer advancements such as atrioventricular synchronized pacing in VDD mode, atrial stimulation, dual-chamber pacing, and longer battery longevity. Studies comparing LPMs with transvenous pacemakers (TVPMs) show a lower rate of device-related complications with LPMs. In the near future, LPMs could be combined with other devices such as non-transvenous implantable cardioverter-defibrillators to provide anti-tachycardia pacing or bradycardia pacing. Future prospectives for leadless cardiac resynchronization therapy and leadless conduction system pacing are being investigated. As LPMs continue to improve, their applications are anticipated to expand further improving patient outcome, promising a bright future for leadless pacing. In this review, the past, present, and future of leadless pacing are discussed with a focus on cutting-edge implantation techniques, clinical outcomes, and modern advancements of LPMs.</p>","PeriodicalId":11976,"journal":{"name":"European Heart Journal","volume":" ","pages":""},"PeriodicalIF":37.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}