Table 3.
Comparison of screening algorithms for pulmonary hypertension in systemic sclerosis
| Approach | False negatives, % (missed diagnoses) | Sensitivity, % | Specificity, % | PPV, % | NPV, % |
|---|---|---|---|---|---|
| SDE at rest and during exercise | 1 | 96 | 82 | 68 | 98 |
| N = 76 | |||||
| DETECT algorithm | 4 | 96 | 48 | 35 | 98 |
| N = 319 | |||||
| DETECT algorithm with | 15 | 85 | 72 | 47 | 94 |
| 65 % specificity at step 2 | |||||
| N = 319 | |||||
| DETECT data with algorithm from | |||||
| ESC/ERS guidelines* | 29 | 71 | 69 | 40 | 89 |
| N = 371 |
PPV positive predictive value (confirmed pulmonary arterial hypertension out of all right heart catheterization referrals), NPV negative predictive value, SDE stress Doppler echocardiography, ESC/ERS European Society of Cardiology/European Respiratory Society
Adaptation of the table provided by Coghlan et al. [11] in the DETECT study
*Evaluated on a subset of patients from DETECT study (n = 371) with available data for the variables defined in the guideline
Criteria were the following: (a) tricuspid regurgitant jet velocity >3.4 m/s or (b) tricuspid regurgitant jet velocity >2.8 to ≤ 3.4 m/s AND symptomatic (defined as at least one of the following DETECT parameters: current anginal pain, current syncope/near syncope, current dyspnoea, or presence of peripheral oedema) or (c) tricuspid regurgitant jet velocity ≤2.8 m/s AND symptomatic (defined as above) AND presence of additional echocardiography variables suggestive of pulmonary hypertension (defined as right atrium area >16 cm2 or ratio of right ventricular diameter/left ventricular end diastolic diameter >0.8 or both)