SHFM ƕ0ƕ0applSHFM*MBARTaltTaltTaltLVTaltTaltxTalt Talt@TaltwTbmpLcodecodedata{pref~Vrloc~`tAIB~dtAIBtAINtFRMtFRMLHtFRMtFRMtFRMx(tFRMtFRMtFRMtFRMtFRM4tSTR0tSTRLtSTR,tSTRztSTRxtSTR tSTR@tSTRtSTRtSTRltSTRtSTR4ytSTRôtverw~W/ BOptionsAbout Seattle HF ModelReset Default ValuesUnit Preferences-Background InfoGraph Outcomes-Show LicenseContact informationAbout Seattle HF ModelThis application calculates the probability of survival for an individual with heart failure, based on clinical and laboratory factors. 2004-2009 Wayne Levy and David Linker, University of Washington.OKSystem IncompatibleSystem Version 2.0 or greater is required to run this application.OKValidation ErrorAn attempt was made to change the value in the field "^1" to ^2 ^3. The value ^3 was used instead.OKBiV Pacer not indicatedA Biventricular pacemaker is not indicated unless: QRS > 120 msec and EF <= 35% and NYHA Class >=3 Force this device into the model anyway?OKCancelICD not indicatedAn ICD is not indicated unless: EF <= 35% and NYHA Class 2-3B Force this device into the model anyway?OKCancelLVAD not indicatedAn LVAD is not indicated unless: <= 2 year mean survival and NYHA Class 4 and EF <= 25% Force this device into the model anyway?OKCancelChange defaults?Press OK to change the laboratory values and diuretic doses to the defaults for this NYHA class. Press Cancel to keep current values.OKCancelAlmost ExpiredThis program will expire in ^1. To download a new version, please perform an AutoUpdate. 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RB Bo+iT+iX;i\;i^;i`;ib;id;if;ih;ij ;il;in;ipZ;irl;it;iv;ix;izt;i|;i~;i;i;i;i ;i;ib;ix;iv;iz;i|N^NuSHFM v2.0.2NV/ BBE0HA2% RB Bo%mT%mX5m\5m^5m`5mb5md5mf5mh5m j5ml5mn5mZp5mlr5mt5mv5mx5mtz5m|5m~5m5m5m5m 5m5mb5mx5mv5mz5m|A/NOR@?BgA// NO&$nN^Nu#VERSION2.00SHFM Evaluation License Agreement The University of Washington (UW) and David Linker and Wayne Levy (Developers) give permission for you, a physician knowledgeable in cardiac medicine (You), to use the Seattle Heart Failure Model software version ^0 (SHFM) through ^1. SHFM is a calculator of projected survival at baseline and after interventions for patients with congestive heart failure. UW and the Developers allow You to use SHFM on the following conditions: You acknowledge and agree that the intended audience for the SHFM is health care professionals knowledgeable in cardiac medicine. If You are not a health care provider, You may not use SHFM. You may copy and distribute SHFM from your Palm PDA to your colleagues in cardiac medicine until ^1. You may not modify or publish SHFM. You may not transfer SHFM to persons that are not health care providers. You shall retain in SHFM the copyright, trademark, and other notices pertaining to SHFM as provided by UW. UW reserves the right to modify or make improvements in the SHFM at any time without notice. You agree to provide the Developers with feedback on the use of the SHFM , and that the Developers and UW are permitted to use any information provided by You in making changes to the SHFM. All bug reports and technical questions shall be sent to: shfm@u.washington.edu You acknowledge and agree as a condition of using SHFM , that the information contained in SHFM is intended as a supplement to, and not a substitute for, Your knowledge, expertise, skill and professional judgment. UW makes no representations or warranty on the accuracy, validity, completeness or availability of information or results obtained from the SHFM. Information provided by the SHFM should not be construed to indicate that any particular outcome, treatment or treatment combination is safe, appropriate or effective in any given patient. The model used by SHFM was constructed from past data trends collected from research studies and may not be predictive of a given patient's risks. You acknowledge that the SHFM is solely a physician information resource and is made available as a research courtesy "AS IS," without obligation by UW to provide accompanying services or support. UW owns the intellectual property in SHFM. Nothing contained in this Agreement shall be construed as conferring any right to use in advertising, publicity or other promotional activities any name, trade name, trademark, or other designation of UW or Developers without the express written permission of UW. UW AND THE DEVELOPERS EXPRESSLY DISCLAIM ANY AND ALL WARRANTIES REGARDING THE SHFM , WHETHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES PERTAINING TO MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. UW AND DEVELOPERS WILL NOT BE LIABLE DIRECTLY OR INDIRECTLY FOR ANY PROPERTY DAMAGE, PERSONAL INJURY, LOSS OF USE, INTERRUPTION OF BUSINESS, LOSS OF PROFITS, OR OTHER SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, HOWEVER CAUSED, WHETHER FOR BREACH OF WARRANTY, CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY OR OTHERWISE. (Some jurisdictions do not allow the exclusion or limitation of incidental or consequential damages, so this exclusion and limitation may not apply to You).NVH8BDI.E3G4@@@@@@?NOc&HnNO/NOe?.NOcO dp`"<6 rex`r ex` rex/ / / HmaA/NO=@B'HnE/ Bg/O(*l////a (* "LN^Nu???ݠ??ރ?a)?'f@*`@`@D`@ NVH0&.(. 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Choose the outcome you are interested in from the popup at the middle of the top of the screen. The value on the left represents the outcome with baseline values and treatments, and the value on the right represents what will happen with the new treatments you have chosen.Choose the medications that the patient is currently taking in the left column. In the right column, enter the medications that you are planning to add or continue.Enter the current total daily diuretic doses that the patient is on, in mg/d.Enter the current laboratory values for the patient. If you do not know the value, leave the default value.Enter any current devices that the patient has in the left column. In the right column you may enter any changes in implanted device that is planned. Note that some devices are not indicated based on current guidelines, and if you choose a device that is not indicated, you will get a warning.Previous heart failure risk models stratify patients into three risk groups using peak oxygen consumption (VO2). An individualized estimate of survival in heart failure that incorporates medications and devices has not been reported. The Seattle Heart Failure Model was derived by retrospectively investigating predictors of survival among 1,125 HF patients in PRAISE1 (NYHA 3B-4, EF<30%, amlodipine vs. placebo, 403 deaths). A stepwise Cox proportional hazard model was used to develop a multivariate risk model, which identified age, gender, ischemic etiology, NYHA, ejection fraction, systolic blood pressure, K-sparing diuretic use, statin use, allopurinol use, hemoglobin, % lymphocyte count, uric acid, sodium, cholesterol, and diuretic dose/kg as significant predictors of individual survival. Life saving medications and devices that could not be tested in the PRAISE1 database were added to the model to allow use in diverse heart failure populations. These include medications like ACEI, ARB, beta blockers, aldosterone blockers, and devices like ICDs, BiV pacemakers, BiV ICDs and Left ventricular assist devices (LVAD). This model was then prospectively validated using data from ELITE2 (2,987 subjects, NYHA 2-4, EF<=40%, captopril vs. losartan), University of Washington Depression Cohort (150 patients, NYHA 1-4), Val-HeFT (5,009 patients, NYHA class 2-4, EF <= 40%, valsartan vs. placebo), Italian CHF Registry (872 patients, NYHA class 1-4, any EF, general cardiology practice), and RENAISSANCE (925 patients, NYHA class 2-4, EF <=30%, etanercept vs. placebo). This program allows you to enter a patient's baseline information and additional therapies you are considering. It will calculate the average outcomes (mortality, survival and mean life years of survival) for the baseline characteristics and treatments, and the average outcomes if you implement the therapies you have chosen. DISCLAIMER The intended audience for the SHFM is physicians knowledgeable in cardiac medicine ("User"). The information contained in SHFM is intended as a supplement to, and not a substitute for, the knowledge, expertise, skill and professional judgment of the physician User. Information provided by the SHFM should not be construed to indicate that any particular outcome, treatment or treatment combination is safe, appropriate or effective in any given patient. The model used by SHFM was constructed from past data trends collected from research studies and may not be predictive of a given patient's risks. User acknowledges that the SHFM is solely a physician information resource and is provided "As Is" as a research courtesy by UW. UW DISCLAIMS ANY REPRESENTATIONS OR WARRANTIES REGARDING THE ACCURACY, VALIDITY, COMPLETENESS OR AVAILABILITY OF INFORMATION IN THE SHFM.Medtronic RepresentativeGraph of mortality and survival data with baseline characteristics (solid line) and with additional therapies being considered (dotted line).1-800-MEDTRON(IC)www.medtronic.comSHFM Evaluation License Agreement The University of Washington (UW) and David Linker and Wayne Levy (Developers) give permission for you, a physician knowledgeable in cardiac medicine (You), to use the Seattle Heart Failure Model software version ^0 (SHFM) through ^1. SHFM is a calculator of projected survival at baseline and after interventions for patients with congestive heart failure. UW and the Developers allow You to use SHFM on the following conditions: You acknowledge and agree that the intended audience for the SHFM is health care professionals knowledgeable in cardiac medicine. If You are not a health care provider, You may not use SHFM. You may copy and distribute SHFM from your Palm PDA to your colleagues in cardiac medicine until ^1. You may not modify or publish SHFM. You may not transfer SHFM to persons that are not health care providers. You shall retain in SHFM the copyright, trademark, and other notices pertaining to SHFM as provided by UW. UW reserves the right to modify or make improvements in the SHFM at any time without notice. You agree to provide the Developers with feedback on the use of the SHFM , and that the Developers and UW are permitted to use any information provided by You in making changes to the SHFM. All bug reports and technical questions shall be sent to: shfm@u.washington.edu You acknowledge and agree as a condition of using SHFM , that the information contained in SHFM is intended as a supplement to, and not a substitute for, Your knowledge, expertise, skill and professional judgment. UW makes no representations or warranty on the accuracy, validity, completeness or availability of information or results obtained from the SHFM. Information provided by the SHFM should not be construed to indicate that any particular outcome, treatment or treatment combination is safe, appropriate or effective in any given patient. The model used by SHFM was constructed from past data trends collected from research studies and may not be predictive of a given patient's risks. You acknowledge that the SHFM is solely a physician information resource and is made available as a research courtesy "AS IS," without obligation by UW to provide accompanying services or support. UW owns the intellectual property in SHFM. Nothing contained in this Agreement shall be construed as conferring any right to use in advertising, publicity or other promotional activities any name, trade name, trademark, or other designation of UW or Developers without the express written permission of UW. UW AND THE DEVELOPERS EXPRESSLY DISCLAIM ANY AND ALL WARRANTIES REGARDING THE SHFM , WHETHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES PERTAINING TO MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. UW AND DEVELOPERS WILL NOT BE LIABLE DIRECTLY OR INDIRECTLY FOR ANY PROPERTY DAMAGE, PERSONAL INJURY, LOSS OF USE, INTERRUPTION OF BUSINESS, LOSS OF PROFITS, OR OTHER SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, HOWEVER CAUSED, WHETHER FOR BREACH OF WARRANTY, CONTRACT, TORT (INCLUDING NEGLIGENCE), STRICT LIABILITY OR OTHERWISE. (Some jurisdictions do not allow the exclusion or limitation of incidental or consequential damages, so this exclusion and limitation may not apply to You).In order to use this program, you must choose "Agree". If you choose "Disagree", you will not be able to use the program, but it will still be on your Palm device. If you choose to run the program again, you will have another opportunity to read the license agreement and choose whether to agree or disagree again.This form allows you to choose kilograms versus pounds for weight, and SI versus American units for hemoglobin, uric acid and cholesterol values. Note that for SI units, uric acid is in mmol/L.2.02