{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T23:01:31Z","timestamp":1768777291321,"version":"3.49.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,5,22]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The 4\u2010variable risk score from University of California, Los Angeles (\n              <jats:styled-content style=\"fixed-case\">UCLA)<\/jats:styled-content>\n              demonstrated superior discrimination in advanced heart failure, compared to established risk scores. However, the model has not been externally validated, and its suitability as a selection tool for heart transplantation (HT) and left ventricular assist device (LVAD) is unknown.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We calculated the\n              <jats:styled-content style=\"fixed-case\">UCLA<\/jats:styled-content>\n              risk score (based on B\u2010type natriuretic peptide, peak\n              <jats:styled-content style=\"fixed-case\">VO<\/jats:styled-content>\n              <jats:sub>2<\/jats:sub>\n              , New York Heart Association class, and use of angiotensin\u2010converting enzyme inhibitor or angiotensin receptor blocker) in 180 patients referred for HT. The outcome was survival free from urgent transplantation or LVAD. The model\u2010predicted survival was compared to Kaplan\u2010Meier's estimated survival at 1, 2, and 3\u00a0years. Model discrimination and calibration were assessed. During a mean follow\u2010up of 2.1\u00a0years, 37 (21%) events occurred. One\u2010, 2\u2010 and 3\u2010year observed event\u2010free survival was 88%, 81%, and 75%, and the observed\/predicted ratio was 0.97, 0.96, and 0.97, respectively. Time\u2010dependent receiver operating characteristic curve analyses demonstrated good discrimination overall (1\u2010year area under curve, 0.801; 2\u2010year, 0.774; 3\u2010year, 0.837), but discrimination between the 2 highest risk groups was poor. The difference between observed and predicted survival ranged from \u221214 to +17 percentage points, suggesting poor model calibration. Fairly similar results were found when the analyses were repeated in 715 patients after multivariate imputation of missing data.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              The\n              <jats:styled-content style=\"fixed-case\">UCLA<\/jats:styled-content>\n              4\u2010variable risk model calibration was inconsistent and high\u2010risk discrimination was poor in an external validation cohort. Further model assessment is warranted before widespread use.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.114.000998","type":"journal-article","created":{"date-parts":[[2014,6,7]],"date-time":"2014-06-07T07:25:38Z","timestamp":1402125938000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Assessment of a University of California, Los Angeles 4\u2010Variable Risk Score for Advanced Heart Failure"],"prefix":"10.1161","volume":"3","author":[{"given":"Ulrik","family":"Sartipy","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Surgery and Anesthesiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayumi","family":"Goda","sequence":"additional","affiliation":[{"name":"Cardiology Department, Kyorin University, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donna M.","family":"Mancini","sequence":"additional","affiliation":[{"name":"Center for Advanced Cardiac Care, Columbia University Medical Center, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lars H.","family":"Lund","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000404"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301247"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2011.05.012"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2010.09.007"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.110.944280"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.023"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.03.025"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1522"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-11-200906020-00007"},{"key":"e_1_3_3_12_2","article-title":"A note on the evaluation of novel biomarkers: do not rely on integrated discrimination improvement and net reclassification index","author":"Hilden J","year":"2013","unstructured":"Hilden J, Gerds TA. A note on the evaluation of novel biomarkers: do not rely on integrated discrimination improvement and net reclassification index. Stat Med. 2013 (In press).","journal-title":"Stat Med"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2841"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs337"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejhf.32"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.08.006"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.114.000998","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:26:44Z","timestamp":1715596004000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.114.000998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,22]]},"references-count":15,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2014,5,22]]}},"alternative-id":["10.1161\/JAHA.114.000998"],"URL":"https:\/\/doi.org\/10.1161\/jaha.114.000998","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,22]]},"assertion":[{"value":"2014-04-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-05-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-06","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000998"}}