Key result
A simplified CHD severity classification system using cardiac morphology as a stand-alone predictor effectively stratified disease severity, showing broad agreement among clinicians.
Why the study?
Complexity stratification is integral to CHD research given heterogeneous presentation and outcomes, but simplified classification tools are needed for researchers lacking specialist CHD knowledge or medical record access.
A simplified CHD severity classification system based solely on cardiac morphology provides an effective tool for disease stratification in research settings, particularly for non-specialists.
May facilitate CHD research by non-specialists; leaves open validation before wider adoption.
BACKGROUND: Complexity stratification for CHD is an integral part of clinical research due to its heterogenous clinical presentation and outcomes. To support our ongoing research efforts into CHD requiring disease severity stratifications, a simplified CHD severity classification system was developed and verified, with potential utility for clinical researchers without specialist CHD knowledge or access to clinical/medical records. METHOD: A two-tiered analysis approach was undertaken. First-tier analysis included the audit of a comprehensive system based on: i) timing of intervention, ii) cardiac morphology, and iii) cardiovascular physiology using real patient data (n = 30), across 10 common CHD lesions. Second-tier analysis allowed for a simplified version of the classification system using morphology as a stand-alone predictor. Twelve clinicians of varying specialities involved in CHD care ranked 10 common lesions from least to most severe based on typical presentation and clinical course. RESULTS: First-tier analysis identified that cardiac morphology was the principal driver of complexity. Second-tier analysis largely confirmed the ranking and classification of the lesions into the broad CHD severity groups, although some variation was noted, specifically among non-cardiac specialists. This simplified version of the classicisation system, with morphology as a stand-alone predictor of severity, allowed for effective stratification for the purposes of analysis. CONCLUSION: The findings presented here support this comprehensive and simple CHD severity classification system with broad utility in CHD research, particularly among clinicians and researchers with limited knowledge of CHD. The model may be applied to produce locally relevant research tools.
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O’Malley et al. (2024) studied Congenital Heart Disease (CHD) (n=30). Simplified CHD severity classification system (morphology only) vs. Comprehensive classification system (morphology, timing of intervention, physiology) was evaluated on Validation of morphology as a stand-alone predictor of CHD severity. A simplified CHD severity classification system using cardiac morphology as a stand-alone predictor effectively stratified disease severity, showing broad agreement among clinicians.
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