California Cardiovascular Screening Tool: Findings from Initial Implementation

AJP Reports
Elizabeth A BlumenthalAfshan Hameed

Abstract

Objective  American College of Obstetricians and Gynecologists (ACOG) recently published the California (CA) cardiovascular disease (CVD) screening algorithm for pregnant and postpartum women. We aim to prospectively determine screen-positive and true-positive rates of CVD among women across two populations. Study Design  This is a prospective cohort study of obstetrical patients from April 2018 to July 2019 at academic medical centers in CA and New York (NY). We attempted to screen all patients at least once during their pregnancy care (prenatal or postpartum). Women who screened positive ("Red Flags," >3-4 moderate risk factors, abnormal physical examination, and persistent symptoms) underwent further testing. The primary outcome was the screen-positive rate. Secondary outcomes included the true-positive rate and the strength of each moderate factor in predicting a positive CVD screen. Results  We screened 846 women. The overall screen-positive rate was 8% (5% in CA vs. 19% in NY). The sites differed in ethnicity, that is, African American women (2.7% in CA vs. 35% in NY, p  < 0.01) and substance use (2.7 vs. 5.6%, p  < 0.04). The true-positive rate was 1.5% at both sites. The percentage of screen-positive patients who did no...Continue Reading

References

Apr 29, 2014·American Journal of Obstetrics and Gynecology·Ralph R ScholtenMarc E A Spaanderman
May 17, 2015·American Journal of Obstetrics and Gynecology·Afshan B HameedElyse Foster
Jul 15, 2015·Seminars in Perinatology·Puja K MehtaC Noel Bairey Merz
Jan 19, 2019·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Rachel A GladstoneGraeme N Smith
Apr 26, 2019·Obstetrics and Gynecology·UNKNOWN American College of Obstetricians and Gynecologists' Presidential Task Force on Pregnancy and Heart Disease and Committee on
Apr 27, 2019·Journal of the American College of Cardiology·Abbi D Lane-CordovaSanjiv J Shah
May 10, 2019·MMWR. Morbidity and Mortality Weekly Report·Emily E PetersenWanda Barfield
Aug 14, 2019·Journal of Women's Health·Pensee WuMartha Gulati
Sep 6, 2019·MMWR. Morbidity and Mortality Weekly Report·Emily E PetersenWanda Barfield

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