Isidora Milosavljević, Ivan Petrović, Aleksandra Ilić, Dragana Dabović, Aleksandra Milovančev, Goran Remer, Vladimir Vuković, Dimitrije Zdravković, Maja Stefanović, Snežana Stojšić, Ana Balenović, Goran Lončar, Snežana Tadić, Milana Jaraković, Snežana Bjelić, Snežana Čemerlić, Marija Bjelobrk, Tatjana Miljković, Andrej Preveden, Milovan Petrović, Srdjan Maletin, Tanja Popov, Vanja Drljević Todić, Mirko Todić, Aleksandra Vulin, Milenko Čanković, Dragica Andrić, Dragoslava Živkov Šaponja, Aleksandar Redžek, Anastazija Stojšić Milosavljević
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Therefore, this research aimed to analyse the possibility of implementing CDSS, compliance of the physicians with the CDSS recommendations, as well as identify obstacles and facilitators to its usage.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>This mixed-methods study was conducted over a 1 year period at the Institute of Cardiovascular Diseases of Vojvodina (Sremska Kamenica, Serbia). The retrospective component included an analysis of patients who had symptoms and/or signs of HF, with an ejection fraction (EF) of ≥50%. The Heart Failure Association pre-test assessment, echocardiography and natriuretic peptide, functional testing, final aetiology (HFA-PEFF) score was used to build a CDSS and to calculate the probability scores for these patients. The prospective component involved an electronic survey that was used to gain feedback from physicians about the CDSS.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The sample included 225 patients, out of which 194 (86.2%) had the HFA-PEFF score of 5–6, suggesting probable HFpEF. This syndrome was clinically documented in the discharge report in only 32 (16.5%) of these patients. The response rate of the survey was 83.3%, including physicians at different levels of education. Barriers to CDSS usage included a lack of echocardiographic skills and knowledge about phenotype profiling in HFpEF patients. An increase in explainability and transparency, as well as staff education, were mentioned as the main facilitators.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The CDSS demonstrated reasonable effectiveness in diagnosing and classifying patients with symptoms of HF if the measured EF was ≥50%. The conducted survey highlighted that physician education, in both CDSS- and HFpEF-related domains, is a key factor in the battle against HFpEF.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 5","pages":"3655-3666"},"PeriodicalIF":3.7000,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15397","citationCount":"0","resultStr":"{\"title\":\"Facilitators, barriers, and insights using an HFA-PEFF-based clinical decision support system: A proof-of-concept study\",\"authors\":\"Isidora Milosavljević, Ivan Petrović, Aleksandra Ilić, Dragana Dabović, Aleksandra Milovančev, Goran Remer, Vladimir Vuković, Dimitrije Zdravković, Maja Stefanović, Snežana Stojšić, Ana Balenović, Goran Lončar, Snežana Tadić, Milana Jaraković, Snežana Bjelić, Snežana Čemerlić, Marija Bjelobrk, Tatjana Miljković, Andrej Preveden, Milovan Petrović, Srdjan Maletin, Tanja Popov, Vanja Drljević Todić, Mirko Todić, Aleksandra Vulin, Milenko Čanković, Dragica Andrić, Dragoslava Živkov Šaponja, Aleksandar Redžek, Anastazija Stojšić Milosavljević\",\"doi\":\"10.1002/ehf2.15397\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and aims</h3>\\n \\n <p>Knowing that heart failure (HF) with preserved ejection fraction (HFpEF) can be difficult to diagnose, a clinical decision support system (CDSS), with functional, morphological and biomarker domains, was built. 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Facilitators, barriers, and insights using an HFA-PEFF-based clinical decision support system: A proof-of-concept study
Background and aims
Knowing that heart failure (HF) with preserved ejection fraction (HFpEF) can be difficult to diagnose, a clinical decision support system (CDSS), with functional, morphological and biomarker domains, was built. Therefore, this research aimed to analyse the possibility of implementing CDSS, compliance of the physicians with the CDSS recommendations, as well as identify obstacles and facilitators to its usage.
Methods
This mixed-methods study was conducted over a 1 year period at the Institute of Cardiovascular Diseases of Vojvodina (Sremska Kamenica, Serbia). The retrospective component included an analysis of patients who had symptoms and/or signs of HF, with an ejection fraction (EF) of ≥50%. The Heart Failure Association pre-test assessment, echocardiography and natriuretic peptide, functional testing, final aetiology (HFA-PEFF) score was used to build a CDSS and to calculate the probability scores for these patients. The prospective component involved an electronic survey that was used to gain feedback from physicians about the CDSS.
Results
The sample included 225 patients, out of which 194 (86.2%) had the HFA-PEFF score of 5–6, suggesting probable HFpEF. This syndrome was clinically documented in the discharge report in only 32 (16.5%) of these patients. The response rate of the survey was 83.3%, including physicians at different levels of education. Barriers to CDSS usage included a lack of echocardiographic skills and knowledge about phenotype profiling in HFpEF patients. An increase in explainability and transparency, as well as staff education, were mentioned as the main facilitators.
Conclusions
The CDSS demonstrated reasonable effectiveness in diagnosing and classifying patients with symptoms of HF if the measured EF was ≥50%. The conducted survey highlighted that physician education, in both CDSS- and HFpEF-related domains, is a key factor in the battle against HFpEF.
期刊介绍：
ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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