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Performance of the "CCS Algorithm" in real world patients.

ABSTRACT: With the publication of the 2014 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation, the Canadian Cardiovascular Society Atrial Fibrillation Guidelines Committee has introduced a new triage and management algorithm; the so-called "CCS Algorithm". The CCS Algorithm is based upon expert opinion of the best available evidence; however, the CCS Algorithm has not yet been validated. Accordingly, the purpose of this study is to evaluate the performance of the CCS Algorithm in a cohort of real world patients.We compared the CCS Algorithm with the European Society of Cardiology (ESC) Algorithm in 172 hospital inpatients who are at risk of stroke due to non-valvular atrial fibrillation in whom anticoagulant therapy was being considered.The CCS Algorithm and the ESC Algorithm were concordant in 170/172 patients (99% of the time). There were two patients (1%) with vascular disease, but no other thromboembolic risk factors, which were classified as requiring oral anticoagulant therapy using the ESC Algorithm, but for whom ASA was recommended by the CCS Algorithm.The CCS Algorithm appears to be unnecessarily complicated in so far as it does not appear to provide any additional discriminatory value above and beyond the use of the ESC Algorithm, and its use could result in under treatment of patients, specifically female patients with vascular disease, whose real risk of stroke has been understated by the Guidelines.

SUBMITTER: LaHaye SA

PROVIDER: S-EPMC5497178 | biostudies-other | 2015 Jun

REPOSITORIES: biostudies-other

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Project description:This study suggests a new nature-inspired metaheuristic optimization algorithm called the red-tailed hawk algorithm (RTH). As a predator, the red-tailed hawk has a hunting strategy from detecting the prey until the swoop stage. There are three stages during the hunting process. In the high soaring stage, the red-tailed hawk explores the search space and determines the area with the prey location. In the low soaring stage, the red-tailed moves inside the selected area around the prey to choose the best position for the hunt. Then, the red-tailed swings and hits its target in the stooping and swooping stages. The proposed algorithm mimics the prey-hunting method of the red-tailed hawk for solving real-world optimization problems. The performance of the proposed RTH algorithm has been evaluated on three classes of problems. The first class includes three specific kinds of optimization problems: 22 standard benchmark functions, including unimodal, multimodal, and fixed-dimensional multimodal functions, IEEE Congress on Evolutionary Computation 2020 (CEC2020), and IEEE CEC2022. The proposed algorithm is compared with eight recent algorithms to confirm its contribution to solving these problems. The considered algorithms are Farmland Fertility Optimizer (FO), African Vultures Optimization Algorithm (AVOA), Mountain Gazelle Optimizer (MGO), Gorilla Troops Optimizer (GTO), COOT algorithm, Hunger Games Search (HGS), Aquila Optimizer (AO), and Harris Hawks optimization (HHO). The results are compared regarding the accuracy, robustness, and convergence speed. The second class includes seven real-world engineering problems that will be considered to investigate the RTH performance compared to other published results profoundly. Finally, the proton exchange membrane fuel cell (PEMFC) extraction parameters will be performed to evaluate the algorithm with a complex problem. The proposed algorithm will be compared with several published papers to approve its performance. The ultimate results for each class confirm the ability of the proposed RTH algorithm to provide higher performance for most cases. For the first class, the RTH mostly got the optimal solutions for most functions with faster convergence speed. The RTH provided better performance for the second and third classes when resolving the real word engineering problems or extracting the PEMFC parameters.

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Performance of the "CCS Algorithm" in real world patients.

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