Key result
An automated EMR-based VEST algorithm demonstrated 100% correlation with manual scores and identified 354 high-risk patients, aiding in appropriate referral for right heart catheterization.
Why the study?
PAH remains underrecognized and life-threatening due to limited awareness, nonspecific symptoms, and late referral to accredited PH centers.
Does an automated EMR-based VEST algorithm accurately calculate scores to identify patients at high risk for pulmonary arterial hypertension and aid referral to specialty care?
Observational (n=4,952)
No
Does an automated EMR-based VEST algorithm accurately calculate scores to identify patients at high risk for pulmonary arterial hypertension and aid referral to specialty care?
An automated EMR-based VEST calculator accurately identifies patients at high risk for PAH, highlighting gaps in current referral practices and offering a tool to prompt earlier diagnosis and expert care.
BACKGROUND: Pulmonary arterial hypertension (PAH) remains underrecognized and life-threatening due to limited awareness, nonspecific symptoms, and late referral to accredited pulmonary hypertension (PH) centers. The previously validated virtual echocardiography screening tool (VEST) predicts PAH hemodynamics. The objectives of the present study were to determine if the novel automated electronic medical record (EMR)-based algorithm could accurately calculate VEST scores to identify PAH hemodynamics and aid referral to PH specialty care. METHODS: This study is a retrospective analysis of 4,952 patients who underwent transthoracic echocardiogram (TTE) with tricuspid regurgitation velocity (TRV) ≥2.9 m/s in a hospital with an accredited PH Center of Comprehensive Care. Using the automated EMR-based algorithm, EMR-calculated VEST scores were calculated and compared to manually calculated VEST scores. Automated EMR VEST scores were used to identify those with highest risk for PAH (+3 score). Patients with +3 score were analyzed to determine whether they were evaluated within the accredited PH center or undergone right heart catheterization (RHC), the gold standard for PH diagnosis. RESULTS: Automated EMR VEST scores were validated with 100% correlation to 60 manual scores. Of 354 patients with +3 score, those that underwent RHC had severe PH, with mean pulmonary artery pressure 48 mm Hg and pulmonary vascular resistance 8.5 Wood units. One hundred and four patients (29.4%) were never referred for specialty PH care, and of these, only 37.5% underwent RHC. In the 250 patients referred to subspecialty PH care, 237 (94.8%) underwent RHC. CONCLUSIONS: This novel EMR-based automated VEST calculator is a powerful yet simple scoring tool that can capture patients at high risk for PAH, prompting earlier diagnosis and referrals to accredited PH centers to allow for earlier expert care and implementation of medical therapies.
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Anand et al. (2025) conducted an observational in Pulmonary arterial hypertension (n=4,952). Automated EMR-based VEST algorithm vs. Manual VEST scores was evaluated on Correlation of automated EMR VEST scores to manual scores. An automated EMR-based VEST algorithm demonstrated 100% correlation with manual scores and identified 354 high-risk patients, aiding in appropriate referral for right heart catheterization.
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