Rule-based clinical decision support system for automated assessment of left ventricular diastolic function…

Cohort studyFrontiers in health services· 2026

Rule-based clinical decision support system for automated assessment of left ventricular diastolic function during stress echocardiography.

Gulnora Rozikhodjaeva, Omonulla Juraev, H-Christian Brauweiler, Tom Schaal

Clinical Decision SupportCohort studyQ1IF 2.5

Rule-based decision support matched expert diastolic assessment in 93% of stress echo cases.

Rule-based clinical decision support system for automated assessment of left ventricular diastolic function during stress echocardiography.

Gulnora Rozikhodjaeva … Tom Schaal

Frontiers in health services · 2026 · Q1 in General Medicine

Background

Heart failure with preserved ejection fraction (HFpEF) remains challenging to diagnose due to the complexity of diastolic function assessment during stress echocardiography, where multiple hemodynamic parameters must be evaluated under time pressure.

Methods

A prospective cohort of 134 patients (mean age 61.3 ± 8.7 years) with exertional dyspnea and preserved left ventricular ejection fraction (LVEF >50%) was enrolled, excluding individuals with significant valvular pathologies, arrhythmias, or unstable ischemia.

n = 134 patients

Results

software matched cardiologists on diastolic function calls in most stress echo cases

Matching expert assess

93%

Identifying stress-ind

85%

More results

It demonstrated high diagnostic agreement (ICC > 0.94) and discrimination (AUC = 0.92).

Rule-based outputs, such as "Impaired diastolic reserve" or "Right ventricular dysfunction under load," were based on combinations of parameters (e.g., E/e' > 15, Δe' ≤ 0, TAPSE < 17 mm, PCWR > 12 mmHg).

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Conclusion

The explainable, guideline-compliant Clinical Decision Support Systems enables real-time, transparent analysis of diastolic function, supporting improved diagnostic consistency and augmented physician decision-making in cardiovascular care.

Rule-based clinical decision support system for automated assessment of left ventricular diastolic function during stress echocardiography.

Rule-based clinical decision support system for automated assessment of left ventricular diastolic function during stress echocardiography.

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