{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:37:00Z","timestamp":1790422620517,"version":"4.1.0"},"reference-count":28,"publisher":"European Respiratory Society (ERS)","issue":"5","content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2017,2,6]]},"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:p>Screening for pulmonary arterial hypertension (PAH) in systemic sclerosis (SSc) improves outcomes. The DETECT screening algorithm is recommended in a high-risk SSc subgroup. This study aims to compare prospectively the positive predictive value of screening using the DETECT algorithm and the 2009 European Society of Cardiology\/European Respiratory Society (ESC\/ERS) guidelines, and to compare their cost-effectiveness in an unselected, day-to-day SSc population.<jats:italic>Post hoc<\/jats:italic>, screening according to the 2015 ESC\/ERS guidelines using echocardiographic parameters alone (\u201c2015 echo screening\u201d) or combined with the DETECT algorithm (\u201c2015 combined screening\u201d) in high-risk subjects was analysed.<\/jats:p><jats:p>195 consecutive SSc patients included in the Ghent University Hospital SSc cohort were screened using different algorithms.<\/jats:p><jats:p>The referral rate for right heart catheterisation was 32% (63 out of 195 patients) (46\/4\/13\/34\/40 patients using the DETECT algorithm\/2009 guidelines\/both\/2015 echo screening\/2015 combined screening). Right heart catheterisation was performed in 53 patients (84%) (36 (78%)\/four (100%)\/13 (100%)\/28 (82%)\/32 (80%) patients recommended by the DETECT algorithm\/2009 guidelines\/both\/2015 echo screening\/2015 combined screening). PAH was diagnosed in three patients (incidence 1.5%\u00b7year<jats:sup>\u20131<\/jats:sup>, 95% CI 0.5\u20134.4), in whom all algorithms recommended a right heart catheterisation. The positive predictive value was 6% (95% CI 2\u201317%; three out of 49 patients) for the DETECT algorithm, 18% (95% CI 6\u201341%; three out of 17 patients) for the 2009 guidelines, 23% (95% CI 8\u201350%; three out of 13 patients) for both, 11% (95% CI 4\u201327%; three out of 28 patients) for the 2015 echo screening and 9% (95% CI 3\u201324%; three out of 32 patients) for the 2015 combined screening. The cost was EUR224\/80\/90\/112 per patient using the DETECT algorithm\/2009 guidelines\/2015 echo screening\/2015 combined screening.<\/jats:p><jats:p>Echocardiography may remain a candidate first step for PAH screening in SSc.<\/jats:p>","DOI":"10.1183\/13993003.02275-2016","type":"journal-article","created":{"date-parts":[[2017,5,12]],"date-time":"2017-05-12T00:10:21Z","timestamp":1494547821000},"page":"1602275","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":58,"title":["Screening for pulmonary arterial hypertension in an unselected prospective systemic sclerosis 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