A team of researchers has increased the accuracy of a tool used to predict survival for individuals with World Health Organization Group 1 PH (pulmonary arterial hypertension or PAH). CHEST Journal, the official publication of the American College of Chest Physicians, has published a study by Raymond L. Benza, M.D., a cardiologist at Allegheny General Hospital, Pittsburgh, a PHA-accredited Center of Comprehensive Care, and a team of researchers who have updated a PAH risk score calculator frequently used in the U.S. and abroad — based on data from the Registry to Evaluate Early and Long-Term PAH Disease Management (REVEAL). The researchers updated a “REVEAL 2.0” risk score system, which incorporates different types of PAH, more detailed information about other coexisting diseases such as kidney disease, six-minute walk distance, certain blood tests, pulmonary function tests, right heart catheterization and information from previous hospitalizations.
Clinicians currently use multiple methods to try to assess risk based on measurable parts of the disease. One of these, based on data from the original REVEAL calculator and a predecessor of the REVEAL 2.0 risk score system, uses 12 different measures — such as the six-minute walk distance, type of PAH, certain blood tests and some measures from the right heart catheterization — to create a risk score.
The researchers compared results from the original REVEAL calculator and calculators from other registries with the updated REVEAL 2.0 risk score. They found that scores from REVEAL 2.0 were more closely associated with survival risk than the original REVEAL and other registry scores when looking at previously collected registry data.
More information and research are needed to understand how the different risk scores’ predictions of risk compare with each other. However, accurate prediction of risk is important for both patients and health care professionals to guide treatment strategies for PAH.
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