Heart failure with preserved ejection fraction (HFpEF) accounts for around half of heart failure cases in the UK. In this condition, the heart pumps blood normally but does not fill properly, causing symptoms such as breathlessness, fatigue and dizziness. Researchers at King’s College London, funded by the British Heart Foundation, studied how this condition is diagnosed in patients of different ethnicities.
The team used a natural language processing algorithm, an AI tool that reads and interprets medical text, to analyse electronic health records from a large London hospital. It identified 1,973 patients who met European guidelines for HFpEF: 64% White, 29% Black and 7% Asian. Compared with White patients, Black patients were younger at diagnosis, more often had obesity, diabetes and high blood pressure, and less often had atrial fibrillation. When the researchers compared these results with routine care, they found that Black and Asian patients were more likely to have been missed in routine practice than by the algorithm.
The researchers believe this is linked to the H2FPEF score, which clinicians partly use to diagnose HFpEF and which gives more weight to atrial fibrillation. Black patients were less likely than White patients to reach a score indicating likely HFpEF (26% vs 44%), so relying on this score may lead to more Black patients being missed. The authors conclude that established markers appear to underdiagnose HFpEF in Black patients and that more research is needed to improve diagnostic tools.
Learn more here: https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2024/july/ai-reduces-underdiagnosis-of-common-heart-failure-in-black-patients-new-research-finds
Read the study here: https://doi.org/10.1016/j.jacadv.2024.101064
References:
British Heart Foundation. (2024, July). AI reduces underdiagnosis of common heart failure in Black patients, new research finds.
Brown, S., Biswas, D., Wu, J., Ryan, M., Bernstein, B. S., Fairhurst, N., Kaye, G., Baral, R., Cannata, A., Searle, T., Melikian, N., Sado, D., Lüscher, T. F., Teo, J., Dobson, R., Bromage, D. I., McDonagh, T. A., Vazir, A., Shah, A. M., & O’Gallagher, K. (2024). Race- and ethnicity-related differences in heart failure with preserved ejection fraction using natural language processing. JACC: Advances, 3(8), 101064.