{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:54:34Z","timestamp":1791482074608,"version":"4.3.4"},"reference-count":32,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosdigitalhealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Digit Health"],"abstract":"<jats:p>\n                    Timely detection is crucial to improve outcomes in patients with cardiac amyloidosis (CA) by initiation of guideline-directed disease-modifying treatments. Although confirmatory bone scintigraphy is highly accurate for CA detection, identifying at-risk patients for referral remains challenging. This study aimed to develop and validate a machine learning model,\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    , using structured multimodal electronic health record (EHR) data to guide referrals for confirmatory scintigraphy and monoclonal protein testing. Consecutive all-comer patients (n\u2009=\u200911,616) referred for bone scintigraphy at the Vienna General Hospital (2010\u20132023) were retrospectively included. Patients referred before August 2020 formed the development cohort. The remaining patients comprised the internal validation cohort. External validation was performed at the University Hospital Essen (n\u2009=\u20091,521).\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    was trained using 50 routinely available parameters to predict CA-suggestive uptake (Perugini grade \u22652) and compared with an existing score and clinical routine. High-grade uptake was present in 388 patients (3.0%).\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    demonstrated excellent performance in development (AUC 0.93), independent internal validation (AUC 0.91), and external validation cohort (AUC 0.91), outperforming existing scoring systems and clinical routine. Results were consistent across subgroups, even when crucial predictors were missing. Of the 42\/388 (10.8%) patients missed in clinical routine, 12\/42 (29%) were additionally detected by\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    . The model further conveyed significant prognostic value for mortality and heart failure hospitalization. We present\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    , a validated EHR-based tool for CA risk prediction, available as a web app, allowing application and further evaluation. By improving timely detection and referral,\n                    <jats:italic>Amylo-Detect<\/jats:italic>\n                    may help address diagnostic delays, pending prospective evaluation.\n                  <\/jats:p>","DOI":"10.1371\/journal.pdig.0001637","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T17:22:08Z","timestamp":1791480128000},"page":"e0001637","update-policy":"https:\/\/doi.org\/10.1371\/journal.pdig.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screening for patients at risk for cardiac amyloidosis via electronic health records: A multicenter machine learning development and validation study"],"prefix":"10.1371","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4409-8324","authenticated-orcid":true,"given":"Clemens P.","family":"Spielvogel","sequence":"first","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]},{"name":"Comprehensive Center for Artificial Intelligence in Medicine, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kersting","sequence":"additional","affiliation":[{"name":"University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"],"department":["Department of Nuclear Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Haberl","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]},{"name":"Comprehensive Center for Artificial Intelligence in Medicine, Medical University of Vienna","place":["Vienna, Austria"]},{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Christian Doppler Laboratory for Applied Metabolomics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Autherith","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurenz","family":"Hauptmann","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Yu","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliane","family":"Hennenberg","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-guided Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilian","family":"Kluge","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Moon","sequence":"additional","affiliation":[{"name":"Institute for Artificial Intelligence in Medicine, University Hospital Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Settelmeier","sequence":"additional","affiliation":[{"name":"West German Heart and Vascular Center, University Hospital Essen","place":["Essen, Germany"],"department":["Department of Cardiology and Vascular Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Ning","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]},{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Christian Doppler Laboratory for Applied Metabolomics"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Kumpf","sequence":"additional","affiliation":[{"name":"IT4Science, IT Services & Strategic Information Management, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"K\u00f6fler","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Hofer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Mascherbauer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Mascherbauer","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]},{"name":"University Hospital St. P\u00f6lten, St. P\u00f6lten, Karl Landsteiner University of Health Sciences","place":["Krems an der Donau, Austria"],"department":["Department of Internal Medicine 3"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Kammerlander","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Traub-Weidinger","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of 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Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Kleesiek","sequence":"additional","affiliation":[{"name":"Institute for Artificial Intelligence in Medicine, University Hospital Essen","place":["Essen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Herrmann","sequence":"additional","affiliation":[{"name":"University Hospital Essen, University of Duisburg-Essen","place":["Essen, Germany"],"department":["Department of Nuclear Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Bartko","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, Austria"],"department":["Division of Cardiology, Department of Internal Medicine II"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Hengstenberg","sequence":"additional","affiliation":[{"name":"Medical University of Vienna","place":["Vienna, 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