{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T17:23:08Z","timestamp":1787851388396,"version":"build-2784847793"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100014091","name":"AstraZeneca","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the feasibility and system-level performance of Heart2Miss, a decentralized community-based triage model deploying AI-powered point-of-care ultrasound (AI-POCUS) via a hub-intermediary-spoke approach in diabetes primary care for early heart-failure (HF) detection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>In this prospective study, 1000 adults with diabetes and no known HF were screened over seven months across six primary care clinics (spokes); 985 with complete data were analysed. Novice biomedical and bioscience graduates underwent 4-week training to perform focused three-view handheld AI-POCUS. Images were AI-analysed and verified through the hub\u2013intermediary\u2013spoke pathway. The primary outcome was detection of previously undiagnosed HF. Secondary outcomes included reduction in tertiary-centre burden through the hub\u2013intermediary\u2013spoke pathway and novice sonographer performance. 11.1% (n = 109) had Stage B (pre-HF) and 1.0% (n = 10) Stage C HF (symptomatic HF). Rapid triage ruled out abnormality in 77.3% at the spoke and a further 12.6% after intermediary TTE confirmation, reducing tertiary diagnostic burden by 89.9%. Only 1.0% required tertiary referral. Regarding novice performance, &amp;gt;90% analysable scans were achieved for left-ventricular parameters and &amp;gt;85% for left-atrial volume. After 400 scans, scan time fell from 11.0 \u00b1 5.3\u2005min to 8.3 \u00b1 4.4\u2005min (\u0394 2.31\u2005min, 95% CI 1.52\u20133.11; P &amp;lt; 0.001), and complete three-view capture improved from 88.0% to 92.2% (P = 0.035).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This decentralized hub\u2013intermediary\u2013spoke model combining AI-POCUS, telehealth verification, and a task-shifted bioscience workforce enabled early HF detection while substantially reducing specialist workload, supporting digital health-enabled workforce innovation and pathway redesign in resource-constrained settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjdh\/ztag115","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:13:40Z","timestamp":1786338820000},"source":"Crossref","is-referenced-by-count":0,"title":["Decentralized community-based hub-intermediary-spoke model for rapid cardiac ultrasound triage for early heart failure detection: findings from the Heart2Miss initiative"],"prefix":"10.1093","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2973-5089","authenticated-orcid":false,"given":"Diana Hui Ping","family":"Foo","sequence":"first","affiliation":[{"name":"Clinical Research Centre, Sarawak General Hospital , Kuching 93586 ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1025-0963","authenticated-orcid":false,"given":"John Jui Ping","family":"Yeo","sequence":"additional","affiliation":[{"name":"Clinical Research Centre, Sarawak General Hospital , Kuching 93586 ,","place":["Malaysia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5500-0917","authenticated-orcid":false,"given":"Yenny Yen Yen","family":"Yeo","sequence":"additional","affiliation":[{"name":"Clinical 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