{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:48:54Z","timestamp":1789026534330,"version":"build-2803163510"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Genomic and Precision Medicine"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>While universal screening for Lipoprotein(a) [Lp(a)] is increasingly recommended, &lt;0.5% of patients undergo Lp(a) testing. Here, we assessed the feasibility of deploying Algorithmic Risk Inspection for Screening Elevated Lp(a) (ARISE), a validated machine learning tool, to health system electronic health records to increase the yield of Lp(a) testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>We randomly sampled 100\u2005000 patients from the Yale-New Haven Health System to evaluate the feasibility of ARISE deployment. We also evaluated Lp(a)-tested populations in the Yale-New Haven Health System (n=7981) and the Vanderbilt University Medical Center (n=10\u2005635) to assess the association of ARISE score with elevated Lp(a). To compare the representativeness of the Lp(a)-tested population, we included 456\u2005815 participants from the UK Biobank and 23\u2005280 from 3 US-based cohorts of Atherosclerosis Risk in Communities, Coronary Artery Risk Development in Young Adults, and Multi-Ethnic Study of Atherosclerosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>Among 100\u2005000 randomly selected Yale-New Haven Health System patients, 413 (0.4%) had undergone Lp(a) measurement. ARISE score could be computed for 31\u2005586 patients based on existing data, identifying 2376 (7.5%) patients with a high probability of elevated Lp(a). A positive ARISE score was associated with significantly higher odds of elevated Lp(a) in the Yale-New Haven Health System (odds ratio, 1.87 [95% CI, 1.65\u20132.12]) and the Vanderbilt University Medical Center (odds ratio, 1.41 [95% CI, 1.24\u20131.60]). The Lp(a)-tested population significantly differed from other study cohorts in terms of ARISE features.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>We demonstrate the feasibility of deployment of ARISE in US health systems to define the risk of elevated Lp(a), enabling a high-yield testing strategy. We also confirm the markedly low adoption of Lp(a) testing, which is also being restricted to a highly selected population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circgen.124.004632","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T05:08:53Z","timestamp":1737608933000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Evaluation of a Machine Learning-Guided Strategy for Elevated Lipoprotein(a) Screening in Health Systems"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3197-2657","authenticated-orcid":true,"given":"Arya","family":"Aminorroaya","sequence":"first","affiliation":[{"name":"Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT (A.A., L.S.D., E.K.O., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5664-4126","authenticated-orcid":true,"given":"Lovedeep S.","family":"Dhingra","sequence":"additional","affiliation":[{"name":"Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT (A.A., L.S.D., E.K.O., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-0720","authenticated-orcid":true,"given":"Evangelos K.","family":"Oikonomou","sequence":"additional","affiliation":[{"name":"Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT (A.A., L.S.D., E.K.O., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-6199","authenticated-orcid":true,"given":"Rohan","family":"Khera","sequence":"additional","affiliation":[{"name":"Cardiovascular Data Science (CarDS) Lab, Yale School of Medicine, New Haven, CT (A.A., L.S.D., E.K.O., R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2023.02.050"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1063"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.034311"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy902"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.120.315291"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac361"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2024.03.001"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211023"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905239"},{"key":"e_1_3_3_11_2","unstructured":"Amgen. 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Evaluate SLN360 in participants with elevated lipoprotein(a) at high risk of atherosclerotic cardiovascular disease events. Clinicaltrials.gov. 2022 [cited 2023 Jun 1]. https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT05537571"},{"key":"e_1_3_3_15_2","unstructured":"Eli Lilly and Company. A study of LY3819469 in healthy participants. Clinicaltrials.gov. 2021 [cited 2023 Jun 1]. https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT04914546"},{"key":"e_1_3_3_16_2","unstructured":"Eli Lilly and Company. A study of LY3473329 in healthy participants. 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