Routine Clinical Use Research Articles

Family functioning in the Mozambican context: Results of a psychometric study of the SCORE‐15 scale

AbstractThe Systemic Clinical Outcome and Routine Evaluation (SCORE)‐15 scale is a widely used tool for measuring family functioning across three dimensions: strengths and adaptability, overwhelmed by difficulties, and disrupted communication. This study assessed the factorial validity and reliability of the SCORE‐15 in the Mozambican context. Four‐hundred university students completed the SCORE‐15 scale and the depression, anxiety and hostility subscales of the Brief Symptom Inventory (BSI). The confirmatory factor analysis supported a three‐factor structure that presented adequate model fit and reliability indexes. Poorer family functioning was correlated with psychopathological symptoms, except for the association between depression and disrupted communication. Women revealed higher levels of disrupted communication, while being single was associated with lower levels of being overwhelmed by difficulties and disrupted communication. Age was positively associated with being overwhelmed by difficulties and disrupted communication. The Mozambican version of the SCORE‐15 showed good factorial validity and reliability and can be used in this national diverse socio‐cultural context. Practitioner points SCORE‐15 is a systemic self‐report measure for routine clinical use and research on family relationships. In this study, SCORE‐15 showed evidence of reliability and validity in Mozambique.

Current and future funding streams for paediatric postmortem imaging: European Society of Paediatric Radiology survey results.

BackgroundPerinatal and childhood postmortem imaging has been accepted as a noninvasive alternative or adjunct to autopsy. However, the variation in funding models from institution to institution is a major factor prohibiting uniform provision of this service.ObjectiveTo describe current funding models employed in European and non-European institutions offering paediatric postmortem imaging services and to discuss the perceived barriers to future postmortem imaging service provision.Materials and methodsA web-based 16-question survey was distributed to members of the European Society of Paediatric Radiology (ESPR) and ESPR postmortem imaging task force over a 6-month period (March-August 2021). Survey questions related to the radiologic and autopsy services being offered and how each was funded within the respondent’s institute.ResultsEighteen individual responses were received (13/18, 72.2% from Europe). Only one-third of the institutions (6/18, 33.3%) have fully funded postmortem imaging services, with the remainder receiving partial (6/18, 33.3%) or no funding (5/18, 27.8%). Funding (full or partial) was more commonly available for forensic work (13/18, 72%), particularly where this was nationally provided. Where funding was not provided, the imaging and reporting costs were absorbed by the institute.ConclusionIncreased access is required for the expansion of postmortem imaging into routine clinical use. This can only be achieved with formal funding on a national level, potentially through health care commissioning and acknowledgement by health care policy makers and pathology services of the value the service provides following the death of a fetus or child. Funding should include the costs involved in training, equipment, reporting and image acquisition.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00247-022-05485-6.

A novel angiographic method to estimate arterial blood flow rates using contrast reflux: Effect of injection parameters.

Contrast reflux, which is the retrograde movement of contrast against flow direction, is commonly observed during angiography. Despite a vast body of literature on angiography, the hemodynamic factors affecting contrast reflux have not been studied. Numerous methods have been developed to extract flow from angiography, but the reliability of these methods is not yet sufficient to be of routine clinical use. To evaluate the effect of baseline blood flow rates and injection conditions on the extent of contrast reflux. To estimate arterial flow rates based on measurement of contrast reflux length. Iodinated contrast was injected into an idealized tube as well as a physiologically accurate model of the cervico-cerebral vasculature. A total of 194 high-speed angiograms were acquired under varying "blood" flow rates and injection conditions (catheter size, injection rate, and injection time). The length of contrast reflux was compared to the input variables and to dimensionless fluid dynamics parameters at the catheter-tip. Arterial blood flow rates were estimated using contrast reflux length as well as a traditional transit-time method and compared to measured flow rates. Contrast reflux lengths were significantly affected by contrast injection rate (p < 0.0001), baseline blood flow rate (p= 0.0004), and catheter size (p= 0.04), but not by contrast injection time (p= 0.4). Reflux lengths were found to be correlated to dimensionless fluid dynamics parameters by an exponential function (R2 = 0.6-0.99). When considering the entire dataset in unison, flow estimation errors with the reflux-length method (39% ± 33%) were significantly higher (p= 0.003) than the transit-time method (33% ± 36%). However, when subgrouped by catheter, the error with the reflux-length method was substantially reduced and was significantly lower (14% ± 14%, p < 0.0001) than the transit-time method. Results show correlations between contrast reflux length and baseline hemodynamic parameters that have not been reported previously. Clinically relevant blood flow rate estimation is feasible by simple measurement of reflux length. In vivo and clinical studies are required to confirm these correlations and to refine the methodology of estimating blood flow by reflux.

Echocardiographic Reference Ranges of Non-Invasive Myocardial Work Indices in Newborns.

Background: Myocardial work (MCW), estimated using non-invasive pressure-strain loops, is a novel approach for assessing left ventricular function. MCW offers potential advantages over left ventricular ejection fraction and global longitudinal strain (GLS). This study aimed to establish a reference range for MCW in newborns.Methods and Results: Overall, 113 healthy newborns (mean [±SD] birth weight 3,120±378 g) were included in the study. After entering peripheral systolic and diastolic blood pressure (BP) values, global constructive work (GCW), global work index (GWI), global work efficiency (GWE), and global wasted work (GWW) were calculated using EchoPAC software (version 204). Considering a mean [±SD] GLS of −16.3±2.8%, the mean [±SD] GWI, GCW, GWW, and GWE was 698.7±147.9 mmHg%, 1,008.5±200.1 mmHg%, 58.1±28.1 mmHg%, and 93.1±2.9%, respectively. All MCW parameters in newborns were lower than those previously reported in children and adults. However, GWI and GCW were more closely correlated with BP and GLS, as in adulthood and children. Estimation of the correlation between MCW and the frame rate index revealed no significant correlations among MCW parameters.Conclusions: Cardiac function in newborns was evaluated by assessing MCW. With the establishment of reference ranges and normative MCW data for newborns, routine clinical use and rotational mechanics are likely to become increasingly common. Future studies are needed to determine whether MCW is useful in screening for cardiac illness among newborns.

Guideline from the Japanese society of echocardiography: guidance for the management and maintenance of echocardiography equipment: 2022 focused update.

Echocardiography plays a pivotal role as an imaging modality in modern cardiology practice. Information derived from echocardiography is essential for patient care. The Japanese Society of Echocardiography has promoted echocardiography for routine clinical and research use. One of the missions of the Society is to provide information that is useful for high-quality examinations. To ensure this, we believe that maintaining equipment in good condition and providing a comfortable environment for the examination are important for both the patient and examiner. Thus, the Committee for Guideline Writing of the Japanese Society of Echocardiography originally published brief guidance for the routine use of echocardiography equipment in 2015. In 2018, the committee updated our guidance incorporating the importance of international standardization. In 2022, the committee has revised and updated our guidance in line with the increase in awareness of infection prevention due to the worldwide spread of coronavirus disease 2019 (COVID-19).

CPAP for secondary cardiovascular prevention in obstructive sleep apnoea patients: not only one moon, but many stars.

While continuous positive airway pressure (CPAP) therapy has a strong evidence base for the treatment of obstructive sleep apnoea (OSA), its impact on cardiovascular comorbidity remains unclear. This journal club reviews three recent randomised controlled trials aimed to evaluate the impact of CPAP therapy in secondary prevention of cerebrovascular and coronary heart disease (SAVE trial), comorbid coronary heart disease (RICCADSA trial) and in patients admitted with acute coronary syndrome (ISAACC trial). All three trials included patients with moderate-to-severe OSA and excluded patients with severe daytime sleepiness. When CPAP was compared with usual care, they all reported no difference in a similar primary composite end-point including death from cardiovascular disease, cardiac events, and strokes. These trials faced the same methodological challenges, including a low primary end-point incidence, the exclusion of sleepy patients, and a low CPAP adherence. Therefore, caution must be taken when broadening their results to the wider OSA population. Although randomised controlled trials provide a high level of evidence, they may not be sufficient to capture the diversity of OSA. Large-scale, real-world data may be able to provide a more rounded and generalisable picture of the effects of routine clinical use of CPAP on cardiovascular morbimortality.

Is socket shielding an option in esthetic region?

The implant cannot preserve the surrounding bone from resorption when placed in the extraction socket. After teeth extraction, a change in the bony architecture of the anterior region makes oral rehabilitation difficult by an implant. This leads us to explore such a critical issue and the relevant data were collected from Pubmed, Google Scholar, and Cochrane database and reviewed. Socket shielding technique is intentional retention of the buccal segment of root fragment during the implant placement in the extraction socket. Socket shielding is an effective procedure in minimizing the buccal bone resorption along with minimizing the buccal contour changes it is minimally invasive as the bone graft is optional thus reducing the cost of the treatment procedure. The limited studies were available to support the routine clinical use of the socket shielding technique. Socket shielding seems to become the non-invasive technique for the preservation of hard and soft tissue by dental implant especially in the esthetic zone in the future. Therefore studies should be carried out on a large population to obtained more précised results related to the socket shielding technique.

Abstract 039: Hybrid Intrinsic Frequency Machine Learning Approach For Calculation Of Total Arterial Compliance And Aortic Characteristic Impedance From A Single Carotid Waveform In Heart Failure With Preserved Ejection Fraction

Introduction: Previous studies demonstrated that heat failure with preserved ejection fraction (HFpEF) is characterized by abnormal arterial function and left ventricle (LV)-arterial coupling. Aortic characteristic impedance (Zc) and total arterial compliance (TAC) are well-established biomarkers for quantification of the arterial function. However, the routine clinical use of these biomarkers requires both pressure and flow measurements. Intrinsic Frequency (IF) method is a novel system-based mathematical approach for the analysis of the cardiovascular dynamics that can predict HF events (Cooper et al. Hypertension, 2021 PMID: 33390053). We hypothesized that a hybrid IF-machine learning (ML) approach can compute TAC and Zc from a noninvasive carotid waveform. Method: We used data from the Framingham Heart Study (FHS) (n=6168). The reference values of Zc and TAC were computed from carotid pressure and aortic flow waveforms. IF parameters of carotid pressure waveform were used in a fully connected feed-forward neural network model. The model was trained/validated/tested on 80% of randomly selected data from all FHS data. The final model was tested on the remaining 20% of the data blinded to all stages of ML development. Result: In blind test set data, our IF-ML models showed correlations of r=0.89 and r=0.79 with the reference value of TAC and Zc, respectively (Fig 1). More importantly, the TAC and Zc from our IF-ML models showed strong correlations among HFpEF patients (r=0.9 and r=0.77 respectively) (Fig.1) Conclusion: Since IFs can be measured noninvasively (e.g. an iPhone), this method can be used to facilitate routine and noninvasive evaluation of TAC and Zc in HFpEF.

Serum thymus and activation-regulated chemokine (TARC) levels correlate with atopic dermatitis disease severity in patients < 6 months.

Background: Atopic dermatitis (AD) may develop by 6 months of age, and its severity assessment is essential for appropriate treatments. Scoring Atopic Dermatitis (SCORAD) is suggested to evaluate the severity of AD but is cumbersome for routine clinical use. The serum thymus and activation-regulated chemokine (TARC) is used as a marker of AD severity. However, the normal range of the TARC levels varies by age, and its usefulness for the evaluation of AD severity has not been established in patients ages < 6 months. Here, we evaluated the correlation between serum TARC levels and SCORAD scores in early infancy and sought the optimal cutoff level to indicate AD severity. Methods: The subjects were 35 patients with AD (16 girls and 19 boys; 3-5 months of age) who visited our clinic between April 2015 and March 2017. All the patients were physically examined by a board-certified allergist. The AD severity was determined by using the SCORAD, together with serum levels of TARC, total immunoglobulin E (IgE), lactate dehydrogenase, and peripheral eosinophil counts. Receiver operating characteristic curve analysis was performed to determine the cutoff levels of serum TARC to indicate AD severity. Results: Significant correlations were observed between SCORAD scores and the serum TARC levels, peripheral eosinophil counts, and serum IgE levels (r = 0.640, r = 0.723, r = 0.533, respectively). The optimal cutoff levels of serum TARC to indicate mild and severe AD were <3523 pg/mL (area under the curve [AUC] = 0.856) and >6192 pg/mL (AUC = 0.833), respectively. Conclusion: Although this study had limitations, we suggest that serum TARC is useful as a marker of AD severity in patients <6 months of age.

Supporting Shared Decision-Making and Home Dialysis in End-Stage Kidney Disease.

It has been widely demonstrated that patient education and empowerment, especially involving shared treatment decisions, improve patient outcomes in chronic medical conditions, including chronic kidney disease requiring kidney replacement therapies. Accordingly, regulatory agencies in the US and worldwide recommend shared decision-making for finalizing one’s choice of kidney replacement therapy. It is also recognized that the US needs to substantially increase home dialysis utilization to leverage its positive impacts on patient and healthcare cost-related outcomes. This perspective highlights how the routine clinical use of the recommended practice of shared decision-making can exist in synergy with the system’s goal for increased home dialysis use. It introduces a pragmatic provider checklist, The Nephrologist’s Shared Decision-Making Checklist, grounded in the relevant theories of shared decision-making, and, unlike some research assessments and extant tools, is easy to understand and implement in clinical practice. This qualitative Checklist can help providers ensure that they have co-constructed an SDM experience with the patient and involved caretakers, helping them benefit from the improved outcomes associated with SDM.

1591P Swedish national population-based study of direct oral anticoagulants and low molecular weight heparin treatment for thromboembolism in cancer patients: The OSCAR SWE study

Cancer patients have high increased risk of Venous Thromboembolism (VTE) and treatments have changed lately. ISTH guidelines suggest rivaroxaban and edoxaban as alternatives to Low Molecular Weight Heparin (LMWH) for VTE treatment in certain cancers with low bleeding risk. However, little is known about safety and effectiveness from observational studies in routine clinical use. This is one of 3 studies in the OSCAR program. Optimal anticoagulation treatment duration in cancer patients remains an open question.

Robotic Aortic Valve Replacement Using the Intuity Bioprosthesis Through a Right Lateral Approach.

Robotic technology offers excellent visualization and surgical precision but has not been established for aortic valve surgery. We present the first 2 cases of patients with severe aortic stenosis who underwent successful robotic aortic valve replacement using a lateral approach and the Edwards Intuity® rapid-deployment bioprosthesis. Postoperative recovery was excellent, and both patients were discharged home on the fourth postoperative day. We believe this approach is valuable for robotic aortic valve replacement and may help to finally bridge the gap into routine clinical use, becoming a valuable option for the surgical treatment of the aortic valve in selected patients.

34927 Adverse events associated with dupilumab in the WHO pharmacovigilance

Background: Dupilumab, an anti-IL-4/13, is approved to treat atopic dermatitis and asthma with a favourable adverse event profile in a selected population from trials. Objective: To assess and describe the spectrum of dupilumab adverse events reported in a pharmacovigilance database. Methods: We used Vigibase, the WHO pharmacovigilance database, and included all physician reports with dupilumab as suspected cause. We used the information component (IC), an indicator for disproportionate reporting, and IC025, the lower limit of its 95% credibility interval. IC025>0 is the statistical significance threshold used in Vigibase, meaning that the adverse event is associated with dupilumab. Results: In 4894 physician reports, the median age was 44 years and 1884 patients were female (38%). The most common adverse events were skin disorders, with 53 (32%) associated adverse events, mostly related to atopic dermatitis, alopecia areata (IC025 4.1) and psoriasis-like eruptions (IC025 2.2). Eye disorders displayed 35 (21%) associated adverse events, mainly related to conjunctivitis and keratitis symptoms, infections and infestations, 14 adverse events (8%), mainly related to herpes infections. Musculoskeletal disorders displayed 8 adverse events (5%), blood and lymphatic disorders 5 adverse events, (3%) and immune disorders 5 adverse events (3%), including serum sickness (IC025 3.9). We found no association with serious infections, vascular events, psychiatric disorders or cancer, with the exception of cutaneous T cell lymphoma (IC025 2.8). Discussion: With few serious adverse events in routine clinical use, we confirm dupilumab favorable safety observed in clinical trials, such as the good overall benefit/risk ratio of dupilumab.

Personal dosimetry for positron emitters, and occupational exposures from clinical use of gallium-68

The current status and issues regarding positron dosimetry in nuclear medicine are summarized. The suitability of the United Kingdom Health Security Agency extremity and eye beta-gamma personal thermoluminescence dosemeters are then considered. Monte Carlo modelling is performed to determine their responses and derive sets of calibration factors, along with H p(0.07) and H p(3) conversion coefficients, for carbon-11, nitrogen-13, oxygen-15, fluorine-18 and gallium-68 sources, which are commonly used in positron emission tomography (PET) computed tomography; data for these isotopes is assumed extrapolatable to other positron sources. It is found that the dosemeters are adequate for assessing exposures to PET radionuclides, even if their routine calibrations to caesium-137 were maintained. An idealized set of measurements representing gallium-68 exposure scenarios is then described, including reproducible mock-ups of individuals manipulating vials and syringes. Finally, a short case-study is presented that explores occupational doses during routine clinical use of gallium-68. The extremity dosemeter results demonstrated significant variations dependent upon the exposure conditions, with some seen to be comparatively large; whole-body and eye dose rates per activity were found to be lower. The importance of routine dose monitoring of workers is emphasized, with the need for a longer-termed follow-up study demonstrated.

A comparison of goldmann applanation tonometry and rebound tonometry measurements among patients attending a glaucoma clinic in Southwest Nigeria.

The accurate measurement of intraocular pressure (IOP) is a fundamental basic examination in daily ophthalmic practice and is important in managing many ophthalmic diseases and conditions such as glaucoma, uveitis, and following trauma. Accurate measurement of IOP is particularly important in glaucoma because the intraocular pressure is the most important modifiable risk factor in its management. To compare intraocular pressure (IOP) measurements obtained with the Goldmann applanation (GAT) tonometer to intraocular pressure measurements obtained with the iCare rebound tonometer (RBT) and evaluate the suitability of the iCare tonometer for routine clinical use among adult patients attending a glaucoma clinic in Southwest, Nigeria. The study was a comparative cross-sectional study. A total of 132 eyes of 132 patients were recruited for the study. Three consecutive IOP measurements were obtained with each of the instruments by the same observer. A difference in IOP of ± 3 mmHg between the two instruments was considered clinically significant in this study. The mean IOP measurement from GAT was 15.18 mmHg (±4.26 mmHg) and 16.32 mmHg (±4.48 mmHg) from RBT. The mean central cornea thickness was 520.66 μm (±33.34). Pearson's correlation (r = 0.84) revealed a strong statistically significant correlation between GAT and RBT measurements and paired student t-test revealed a statistically significant difference in the means of IOP obtained by the GAT and RBT. There was a tendency for RBT to yield higher IOP measurements. The intraocular pressure measurements obtained with iCare RBT and GAT though strongly correlated, showed statistically significant differences in the means. The impact of central cornea thickness on measurements obtained by GAT and RBT was statistically insignificant. The iCare rebound tonometer, cannot replace GAT for routine use in the glaucoma clinic.

Interdisciplinary Collaboration Opportunities, Challenges, and Solutions for Artificial Intelligence in Ultrasound.

Ultrasound is one of the most widely utilized imaging tools in clinical practice with the advantages of noninvasive nature and ease of use. However, ultrasound examinations have low reproducibility and considerable heterogeneity due to the variability of operators, scanners, and patients. Artificial Intelligence (AI)-assisted ultrasound has advanced in recent years, bringing it closer to routine clinical use. The combination of AI with ultrasound has opened up a world of possibilities for increasing work productivity and precision diagnostics. In this article, we describe AI strategies in ultrasound, from current opportunities, constraints to potential options for AI-assisted ultrasound.

Determination of salivary concentrations of leptin and adiponectin, ability to reduce ferric ions and total antioxidant capacity of saliva in patients with severe early childhood caries.

IntroductionOne of the most common oral diseases affecting children is early childhood caries (ECC). The link between oxidative stress and ECC has been proven in numerous clinical studies. Technical and biological variability were so high in most of the studies that none of the markers have yet been proven suitable for routine clinical use. This study aimed to evaluate the antioxidant status and the levels of leptin and adiponectin in saliva of children with severe early childhood caries (S-ECC).MethodsMorning unstimulated saliva samples were collected from children (n = 40, 0–6 years old) for the evaluation of oxidative stress which were measured by total antioxidant capacity (TAC), and by the ferric reducing antioxidant power (FRAP) assays, as well as to assess the salivary levels of leptin and adiponectin. FRAP, TAC, leptin and adiponectin concentrations were evaluated in S-ECC group (n = 31) and caries free group CF (n = 9). All results were analyzed based on age and sex.ResultsOverall median salivary leptin and adiponectin levels were 5.59 pg/mL and 24.86 ng/mL, respectively. Significantly lower leptin levels were observed in saliva of caries free children (4.66 pg/mL) than in the S-ECC group (6.64 pg/mL, p < 0.01). No significant difference was observed for adiponectin levels (S-ECC and CF, 25.31 and 23.2 ng/mL, respectively, p = 0.961). TAC and FRAP values of saliva had similar values in children with S-ECC and caries free children. TAC and FRAP values also remained stable with the age of the children, without significant differences with respect to sex.ConclusionThe increased concentrations of leptin in saliva of children with S-ECC suggests that leptin may play a role in inflammatory and immune responses in the development of early childhood caries.

Diffusion tensor imaging pipeline measures of cerebral white matter integrity: An overview of recent advances and prospects.

Cerebral small vessel disease (CSVD) is a leading cause of age-related microvascular cognitive decline, resulting in significant morbidity and decreased quality of life. Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging (MRI), key questions on CSVD remain elusive. Enhanced relationships and reliable lesion studies, such as white matter tractography using diffusion-based MRI (dMRI) are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD. Diffusion tensor imaging (DTI) and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage. However, due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting, interpreting the findings remain contentious, especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use. In this minireview, we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD, even for subclinical CSVD in at-risk individuals.

Model-Informed Rationale for Early Therapeutic Drug Monitoring of Colistin in Critically Ill Patients.

Adequate colistin exposure is important for microbiological clearance. This study was performed in critically ill patients >18 years old to develop a simplified nonparametric pharmacokinetic (PK) model of colistin for routine clinical use and to determine the role of dose optimization. The Non-Parametric Adaptive Grid algorithm within the Pmetrics software package for R was used to develop a PK model from 47 patients, and external validation of the final model was performed in 13 patients. A 1-compartment multiplicative gamma error model with 0-order input and first-order elimination of colistin was developed with creatinine clearance and serum albumin as covariates on elimination rate constant. An R2 for observed vs individual predicted colistin concentrations of 0.92 was obtained in the validation cohort. High interindividual variability in colistin steady-state area under the plasma concentration-time curve (AUC) from from 120 hours to 144 hours (coefficient of variation=80.1%) and a high interoccasion variability (median coefficient of variation of AUC from time 0 to hours predicted every 8hours for initial 96hours after starting colistin=23.8) was predicted in patients who received this antibiotic for a period of over 152hours (n=22). With the model-suggested dose regimen, only 20% of simulated profiles achieved AUC from time 0 to 24 hours in the range of 50 to 60mg• h/L due to high variability in population PK. In this group of patients, steady-state colistin concentrations were predicted to be achieved >96hours after initiation of colistimethate sodium. This study advocates the need for early and repeated therapeutic drug monitoring and dose optimization in critically ill patients to achieve adequate therapeutic concentration of colistin.

Machine learning to predict adverse outcomes after cardiac surgery: A systematic review and meta-analysis.

Machine learning (ML) models are promising tools for predicting adverse postoperative outcomes in cardiac surgery, yet have not translated to routine clinical use. We conducted a systematic review and meta-analysis to assess the predictive performance of ML approaches. We conducted an electronic search to find studies assessing ML and traditional statistical models to predict postoperative outcomes. Our primary outcome was the concordance (C-) index of discriminative performance. Using a Bayesian meta-analytic approach we pooled the C-indices with the 95% credible interval (CrI) across multiple outcomes comparing ML methods to logistic regression (LR) and clinical scoring tools. Additionally, we performed critical difference and sensitivity analysis. We identified 2792 references from the search of which 51 met inclusion criteria. Two postoperative outcomes were amenable for meta-analysis: 30-day mortality and in-hospital mortality. For 30-day mortality, the pooled C-index and 95% CrI were 0.82 (0.79-0.85), 0.80 (0.77-0.84), 0.78 (0.74-0.82) for ML models, LR, and scoring tools respectively. For in-hospital mortality, the pooled C-index was 0.81 (0.78-0.84) and 0.79 (0.73-0.84) for ML models and LR, respectively. There were no statistically significant results indicating ML superiority over LR. In cardiac surgery patients, for the prediction of mortality, current ML methods do not have greater discriminative power over LR as measured by the C-index.