{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T03:06:03Z","timestamp":1779246363901,"version":"3.51.4"},"reference-count":26,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:00:00Z","timestamp":1777852800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Heart Foundation"},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Health and Medical Research Council Research Fellowships"},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council Research Fellowships","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Diagnostic uncertainty is a major barrier to the timely treatment of heart failure (HF) in the prehospital setting. We aimed to develop and validate a decision support tool using readily available clinical variables to predict the probability of HF among dyspnoeic patients transported by emergency medical services (EMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A population-based cohort of all adults transported by EMS for dyspnoea in Victoria, Australia was chronologically split into derivation (2015\u20132017) and temporal validation (2018\u20132019) cohorts. Two models were developed: (i) a full multivariable logistic regression model using adaptive least absolute shrinkage and selection operator regression and (ii) a simplified points-based RAPID-CHF score derived from the nine most predictive variables. Among 271 204 patients with dyspnoea (176 269 derivation; 94 935 validation), 9.4% and 9.0% had HF, respectively. The full model included 19 variables and demonstrated excellent discrimination (AUC 0.861 derivation; 0.862 validation) and calibration. The RAPID-CHF score (range 0\u201313; comprising age, ECG rhythm, prior HF, conscious state, oxygen saturation, blood pressure, temperature, peripheral oedema, and crackles) retained strong performance (AUC 0.835 derivation; 0.836 validation) and calibration. HF prevalence increased across predefined risk categories: low (score 0\u20135; HF prevalence 1.7%), moderate (6\u20139; 13.6%) and high (10\u201313; 46.4%). Decision curve analysis demonstrated greater net benefit across clinically relevant thresholds than current EMS diagnosis or \u2018treat all\u2019\/\u2018treat none\u2019 strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A risk score derived from routinely collected prehospital variables accurately estimates HF probability among EMS-transported patients with dyspnoea. The RAPID-CHF score may facilitate earlier diagnosis and timely initiation of HF therapy in EMS workflows.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuag138","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:28:09Z","timestamp":1777638489000},"source":"Crossref","is-referenced-by-count":0,"title":["A prehospital decision support tool for the diagnosis of acute heart failure: the RAPID-CHF score"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4801-2388","authenticated-orcid":false,"given":"Jennifer Y","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Cardiology, Alfred Hospital , 55 Commercial Road, Melbourne VIC 3004 ,","place":["Australia"]},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University , Melbourne ,","place":["Australia"]},{"name":"Baker Heart and Diabetes Institute , Melbourne ,","place":["Australia"]},{"name":"Centre for Research and Evaluation, Ambulance Victoria , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1512-4255","authenticated-orcid":false,"given":"Jocasta","family":"Ball","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Nehme","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Research and Evaluation, Ambulance Victoria , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Anderson","sequence":"additional","affiliation":[{"name":"Ambulance Victoria , Melbourne ,","place":["Australia"]},{"name":"Department of Paramedicine, Monash University , Melbourne, Victoria ,","place":["Australia"]},{"name":"Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Mahony","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Research and Evaluation, Ambulance Victoria , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tegwyn","family":"McManamny","sequence":"additional","affiliation":[{"name":"Ambulance Victoria , Melbourne ,","place":["Australia"]},{"name":"Department of Paramedicine, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesslyn","family":"Wijaya","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Research and Evaluation, Ambulance Victoria , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shane","family":"Nanayakkara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Alfred Hospital , 55 Commercial Road, Melbourne VIC 3004 ,","place":["Australia"]},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Alfred Hospital , 55 Commercial Road, Melbourne VIC 3004 ,","place":["Australia"]},{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Monash-Alfred-Baker Centre for Cardiovascular Research, Monash University , Melbourne ,","place":["Australia"]},{"name":"Baker Heart and Diabetes Institute , Melbourne ,","place":["Australia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2432-1645","authenticated-orcid":false,"given":"Ziad","family":"Nehme","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University , Melbourne ,","place":["Australia"]},{"name":"Centre for Research and Evaluation, Ambulance Victoria , Melbourne ,","place":["Australia"]},{"name":"Department of Paramedicine, Monash University , Melbourne, Victoria 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