{
  "abstract": "Background: Transthyretin amyloidosis (ATTR) diagnoses are frequently delayed or missed, attenuating treatment benefit.\n\nObjectives: The authors developed an explainable artificial intelligence screening tool to identify high-risk patients who should be considered for diagnostic testing for ATTR-cardiomyopathy (ATTR-CM) from an unselected heart failure (HF) population.\n\nMethods: Electronic health record data (April 2020–March 2023) were used to identify patients with suspected ATTR-CM in an HF cohort. Natural language processing with Named Entity Recognition processed unstructured clinical, echocardiographic, and electrocardiographic data. Clinical ModernBERT predicted suspected ATTR-CM. Local interpretable model-agnostic explanations were provided. The authors examined sensitivity, specificity, positive predictive value, negative predictive value, F1 score, area under the receiver-operating characteristic curve, and key model predictors.\n\nResults: This study included 100,290 patients with HF (mean age: 71.6 ± 14.3 years; 47.3% female; 76.2% White; 18.2% Black; 89.7% non-Hispanic). The Clinical ModernBERT model, INSIGHT-CM, identified suspected ATTR-CM (n = 1,108; prevalence 1.2%) with sensitivity 77.5% (95% CI: 75.9%-82.8%), specificity 94.7% (95% CI: 94.4%-95.0%), positive predictive value 19.9% (95% CI: 17.6%-22.36%), negative predictive value 99.6% (95% CI: 99.5%-99.7%), and area under the receiver-operating characteristic curve 92.4% (95% CI: 90.5%-94.3%).\n\nConclusions: In an unselected HF population with 1% prevalence of suspected ATTR-CM, INSIGHT-CM identified patients among whom 1 in 5 fit the pattern for suspected ATTR-CM, offering meaningful opportunities to improve timely diagnosis and treatment.",
  "abstract_shown": true,
  "affiliations": [
    "Baylor Scott & White Research Institute, Dallas, Texas, USA",
    "Department of Medicine, Baylor College of Medicine, Temple, Texas, USA",
    "Baylor Scott & White The Heart Hospital Plano, Plano, Texas, USA",
    "Baylor Scott & White The Heart Hospital, Dallas, Texas, USA",
    "Baylor University Medical Center, Dallas, Texas, USA",
    "Texas A&M Health Science Center, Dallas, Texas, USA",
    "Burnett School of Medicine at TCU, Fort Worth, Texas, USA",
    "OHSU-PSU School of Public Health, Oregon Health and Science University, Portland, Oregon, USA",
    "US Medical Affairs, BioPharmaceutical Medical, AstraZeneca, Wilmington, Delaware, USA",
    "University of Mississippi Medical Center, Jackson, Mississippi, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Akshay Arora"
    },
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Muhammad Shahzeb Khan"
    },
    {
      "affs": [
        0
      ],
      "name": "Cynthia Sunderman"
    },
    {
      "affs": [
        0
      ],
      "name": "Nicole Baldwin"
    },
    {
      "affs": [
        0
      ],
      "name": "Monica Bennett"
    },
    {
      "affs": [
        0
      ],
      "name": "Vee Anne Bomar"
    },
    {
      "affs": [
        0
      ],
      "name": "Lisa Cross"
    },
    {
      "affs": [
        0
      ],
      "name": "Briget da Graca"
    },
    {
      "affs": [
        0
      ],
      "name": "Jason Ettlinger"
    },
    {
      "affs": [
        0,
        2,
        3,
        4,
        5,
        6
      ],
      "name": "Robert L. Gottlieb"
    },
    {
      "affs": [
        0
      ],
      "name": "Kendall Hammonds"
    },
    {
      "affs": [
        0
      ],
      "name": "Michael Mack"
    },
    {
      "affs": [
        7
      ],
      "name": "Ahmad Masri"
    },
    {
      "affs": [
        8
      ],
      "name": "Mia Papas"
    },
    {
      "affs": [
        0
      ],
      "name": "Elisa L. Priest"
    },
    {
      "affs": [
        0
      ],
      "name": "Courtney Shaver"
    },
    {
      "affs": [
        8
      ],
      "name": "John Venditto"
    },
    {
      "affs": [
        0,
        9
      ],
      "name": "Javed Butler"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e1n6rv3xh84a7.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jacadv.2026.103122",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13699708/",
  "id": "e1n6rv3xh84a7",
  "issns": [
    "2772-963X"
  ],
  "landing_url": "https://doi.org/10.1016/j.jacadv.2026.103122",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Heart Failure and Cardiomyopathies"
    ],
    [
      "heading",
      "Original Research"
    ],
    [
      "lcc",
      "RC666-701"
    ],
    [
      "lcc",
      "RC86-88.9"
    ],
    [
      "openalex",
      "1312|Amyloidosis: Diagnosis, Treatment, Outcomes"
    ]
  ],
  "openalex": "W7204267322",
  "pdf_url": "https://www.jacc.org/doi/pdf/10.1016/j.jacadv.2026.103122?download=true",
  "pmcid": "PMC13699708",
  "pmid": "42658135",
  "published": "2026-08-26",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/e1n6rv3xh84a7.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:16Z",
      "native_id": "PMC13699708",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jacadv.2026.103122"
    },
    {
      "first_seen": "2026-10-30T13:43:16Z",
      "native_id": "ee39ac5773ac44128310ab5452a35802",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.jacadv.2026.103122"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Amyloidosis: Diagnosis, Treatment, Outcomes",
      "subfield": "molecular-biology"
    }
  ],
  "title": "INSIGHT Model",
  "title_text": "INSIGHT Model",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T13:43:16Z",
  "url": "https://research.draconitic.com/paper/e1n6rv3xh84a7",
  "venue": "JACC: Advances",
  "versions": []
}