standOff, and the article is at its publisher via the link below. When we have changed our mind. Some entries in the table begin with a word in capitals and the reason for it. EVIDENCE CORRECTED — the finding still stands, but we had quoted the wrong sentence from the paper, and the quotation has been replaced with the right one. RETRACTED — the entry itself was wrong; it stays on the page, marked, with the reason, rather than being deleted. WITHDRAWN AND REPLACED — the entry was wrong, and a corrected version of it appears in the entries below. Each mark carries its own reason, in brackets, because the reasons differ from one entry to the next. An entry we have WITHDRAWN is removed from this page and kept in the record, with its reason. A line reading Audit and a date is a later re-reading of the entry against its whole sentence: DOUBTFUL means it was kept, and the reason says what is loose about it. Quotation marks inside the tagger's sentence. Where a tag is the tagger's own sentence, a phrase in quotation marks inside it is borrowed from the paper — the tagger's wording around it is not. The paper's own sentence is the evidence quote for that row; on this page it is withheld with the article, and the article is at its publisher. Nothing inside quotation marks anywhere on this page is ours: if it is quoted, it is the paper's. Whose words a concept carries. A concept entry records a term the paper itself uses, so the term, the sense given for it, and its evidence are the paper's own words, quoted where the paper fixes them. This is the opposite of a sense entry in the tag table, which is the tagger's sentence about how the paper uses a term. Where a concept entry could not be grounded in the paper's words, the entry says so on its own row.| relation to other work | claim_relations | how this paper stands to another: agrees, contradicts, extends, qualifies |
| claim type | claim_type | the shape of the claim: existence, mechanism, method, critique, prediction, null |
| concept edge | concept_edges | an asserted relation between two concepts, with the sentence asserting it |
| concept | concepts | an idea the paper works with, quoted where the paper uses it |
| content tag | content_tags | a finding, definition, quantity, statistic or variable named in the paper |
| contribution | contribution | what the paper claims to add |
| control | controls | an experiment run to eliminate a rival explanation |
| limitation | limitations | what the paper says its evidence cannot support |
| mechanism | mechanisms | how the reported effect is said to come about |
| method | method | how the paper produced its evidence |
| object of study | object_of_study | what the paper is about — the thing it investigates |
| phenomenon | phenomenon | the effect or regularity under study |
| research question | research_question | the question the paper sets itself |
| sense | senses | a distinct use of a term, quoted where the paper fixes it |
Relations on this page carry a quotation for the claim. Where a relation was separately evidenced — and so tested against the vocabulary for its type — the row says so; 7 of 7 relations here carry that mark. The rest are the tagger’s reading of the sentence quoted beside them.
| facet | tag | field | conf. | whose words |
|---|---|---|---|---|
| object_of_study | A DIAGNOSTIC THRESHOLD THAT DEFINED A DISEASE FOR 45 YEARS, LOWERED - pulmonary hypertension moves from mPAP >=25 mmHg, set at the 1st World Symposium in 1973 and called arbitrary in that meeting's own report, to >20 mmHg, the 97.5th percentile of 1187 normal subjects Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | object_of_study | the paper's words | |
| research_question | whether pulmonary hypertension and pre-capillary pulmonary hypertension should be redefined, whether exercise PH should be brought back into the definition, and what the clinical classification should contain Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | research_question | the paper's words | |
| contribution | a haemodynamic definition of pre-capillary PH with three simultaneous conditions - mPAP >20 mmHg, PAWP <=15 mmHg, PVR >=3 WU - a refusal to reintroduce exercise PH, and a simplified clinical classification with two new group 1 subgroups and two demotions out of group 5 Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | contribution | the paper's words | |
| claim_type | method Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | claim_type | the paper's words | |
| phenomenon | a disease whose presence is decided entirely by numbers from a catheter, where the numbers have no natural boundary and the boundary chosen changes who is ill Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | phenomenon | the paper's words | |
| method | expert-consensus Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: expert-consensus | method | the paper's words | |
| mechanisms | THE OLD NUMBER WAS ARBITRARY AND THE 1973 MEETING SAID SO: `it was recognised that this upper limit of normal mPAP of 25 mmHg was somewhat empirical and arbitrarily defined. However, this conservative cut-off value allowed physicians to discriminate severe PH due to primary PH from other forms of PH ... characterised by a lower mPAP.` The threshold was chosen to separate the severe cases from everything else, not to mark where normal ends - a working boundary that became the definition of a disease for 45 years Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[0] | 0.95 | the tagger's words |
| mechanisms | AND IT WAS KEPT FOR ITS CONSEQUENCES, NOT ITS ACCURACY: `This definition REMAINED UNCHANGED during the subsequent WSPH meetings FROM 1998 TO 2013, at least in part to preclude potential overdiagnosis and overtreatment of PH.` Four international meetings declined to move a number they knew was arbitrary, because of what moving it would do. A definition held in place by its downstream effects is the cleanest instance of this in the corpus Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[1] | 0.95 | the tagger's words |
| mechanisms | AND THE NEW NUMBER WAS ALREADY IN THE 1961 REPORT: `In 1961, a report of the World Health Organization (WHO) Expert Committee on Chronic Cor Pulmonale mentioned clearly that the mean pulmonary arterial pressure does not normally exceed 15 mmHg ... and that the value was little affected by age AND NEVER EXCEEDED 20 mmHg.` The 2018 threshold is 20 mmHg. The evidence for the new boundary is 57 years older than the boundary it replaces, and the paper cites it as its first reference Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[2] | 0.95 | the tagger's words |
| mechanisms | AND THE NEW ONE IS A PERCENTILE: from `1187 normal subjects from 47 studies`, `mPAP at rest was 14.0+/-3.3 mmHg`, so `two standard deviations would suggest mPAP >20 mmHg as above the upper limit of normal ( i.e. above the 97.5th percentile). This definition is, therefore, no longer arbitrary, but based on a scientific approach.` The replacement for an arbitrary cut is a distributional convention - mean plus two standard deviations is a choice about how much of a normal population to call abnormal, and 2.5% is as much a convention as 25 mmHg was Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[3] | 0.95 | the tagger's words |
| mechanisms | AND THE COMPANION CRITERION IS ADMITTED TO BE ARBITRARY, FOUR PARAGRAPHS LATER: `This cut-off value of PVR >=3 WU is also quite arbitrary since some recent data suggest that PVR >2 WU could be also considered abnormal. In this sense, the use of a cut-off value of PVR >=3 WU IS CONSERVATIVE.` One definition, two thresholds: one de-arbitrarised by a percentile and one defended as arbitrary and conservative, and the same document says both Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[4] | 0.95 | the tagger's words |
| mechanisms | AND A NUMBER ALONE IS DECLARED INSUFFICIENT TO NAME A DISEASE: `Whatever the mPAP cut-off value considered for defining PH (>=25 or >20 mmHg), it is important to emphasise that this value used in isolation cannot characterise A clinical condition and does not define the pathological process per se.` The pressure can be raised by cardiac output, by a shunt, by wedge pressure or by blood viscosity - so the definition needs a second measurement to say WHERE the resistance is Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[5] | 0.95 | the tagger's words |
| mechanisms | AND THE PATIENTS ADDED BY THE CHANGE HAVE NO EVIDENCE BASE: `a change in the haemodynamic definition of PH due to PVDs does not imply treating these additional patients, but highlights the importance of close monitoring in this population. Prospective trials are required to determine whether this PH population might benefit from specific management.` A diagnosis is extended to people for whom no treatment is indicated and none has been tested - stated plainly, in the section that makes the change Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[6] | 0.95 | the tagger's words |
| mechanisms | AND THE EVIDENCE FOR MOVING IT IS THAT THE EXCLUDED BAND ALREADY BEHAVES LIKE THE DISEASE: of 38 systemic sclerosis patients with mPAP 21-24 mmHg re-catheterised, `16 of these (42%) developed overt PH`, and `Patients with so-called BORDERLINE mPAP at diagnosis were more likely to develop overt PAH than patients with mPAP <=20 mmHg (HR 3.7)`. In a 547-patient Austrian cohort, `both borderline PH and manifest PH were significantly associated with poor survival` (HR 2.37 and 5.05). The band between the old threshold and the new one was never healthy; it was outside the definition Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[7] | 0.95 | the tagger's words |
| mechanisms | AND A DEFINITION REMOVED IN 2008 WAS NOT RESTORED, FOR A MEASUREMENT REASON: `In 2004, PH was defined as resting mPAP >25 mmHg or exercise mPAP >30 mmHg. At the 4th WSPH in 2008, however, the `EXERCISE` part of the definition was removed.` Revisited in 2018 and refused again - `too many uncertainties persist to allow the reintroduction of a clinically useful definition of exercise PH` - because `it was impossible to distinguish LHD from PVD patients with confidence` and the measurement is `impractical as a clinical routine`. A criterion refused on the grounds that it cannot be measured, not that it is untrue Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[8] | 0.95 | the tagger's words |
| mechanisms | AND ONE WHOLE CLASS IS DEFINED BY WHAT IS NOT KNOWN ABOUT ITS MEMBERS: `the concept supporting the classification of a clinical condition ... into group 5 is, again, the lack of robust data allowing a definite recognition of predominant pathophysiological mechanisms, or describing the histopathological findings or yet, describing management strategies.` Group 5 was `disorders directly affecting the pulmonary vasculature` in 1998 and `MISCELLANEOUS` in 2003. Membership is an epistemic state, not a property of the disease - a paper leaves group 5 when the literature improves, not when the patient changes Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[9] | 0.95 | the tagger's words |
| mechanisms | AND TWO MEMBERS WERE DEMOTED FROM CONDITIONS TO RISK FACTORS: splenectomy, because `no other particular phenotype or change in clinical behaviour has been associated with [it], suggesting that it should be better considered as A risk factor for PH instead of A PARTICULAR CONDITION deserving a specific classification`; and thyroid disorders, `IT WAS A CONSENSUS TO WITHDRAW [them] from the classification as A SPECIFIC ENTITY and better discuss their role as risk factors`. The test for being a class rather than a correlate is whether membership predicts anything else Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[10] | 0.95 | the tagger's words |
| mechanisms | AND THE BAR FOR MOVING ANYTHING ELSE IS STATED: `We propose that changes be made only after the generation of robust data to support such reclassification.` A classification that names its own amendment rule - compare the same task force moving two entries out on exactly that ground in the paragraphs above Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | mechanisms[11] | 0.95 | the tagger's words |
| limitations | THE STRONGEST SENTENCE AGAINST THE PAPER IS THE PAPER'S OWN: `This cut-off value of PVR >=3 WU is also quite arbitrary.` The abstract sells the mPAP change as `no longer arbitrary, but based on a scientific approach`; the definition it proposes requires BOTH numbers, and only one of them has been de-arbitrarised. A definition is no more principled than its least principled conjunct Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | limitations[0] | 0.95 | the tagger's words |
| limitations | AND `no longer arbitrary` MEANS `A DIFFERENT CONVENTION`: mean plus two standard deviations in `1187 normal subjects from 47 studies` is a rule about how much of a healthy population to place outside normal - `above the 97.5th percentile`. It is reproducible, auditable and far better than a show of hands, and it is still a choice of tail. The paper does not claim 20 mmHg is where the pathology starts; it claims it is where the normal distribution ends Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | limitations[1] | 0.95 | the tagger's words |
| limitations | AND THE NEW DIAGNOSIS COMES WITH NOTHING TO DO ABOUT IT: `Prospective trials are required to determine whether this PH population might benefit from specific management.` The task force is explicit that widening the definition `does not imply treating these additional patients` - which is the right disclosure, and leaves every patient newly inside the boundary with a disease name and a monitoring plan Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | limitations[2] | 0.95 | the tagger's words |
| limitations | AND THE OVERDIAGNOSIS ARGUMENT IS ANSWERED BY REDIRECTING IT: `For many years, the diagnosis of PH was based on an arbitrary value ... probably because of understandable concern about overdiagnosis and overtreatment. Actually, the main cause of overdiagnosis ... is the failure to confirm the diagnosis by RHC.` The reply is that overdiagnosis comes from skipping the catheter rather than from where the line sits - true, and it does not measure how many more people the new line admits, which this paper does not estimate Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | limitations[3] | 0.95 | the tagger's words |
| limitations | AND THE DISCLOSURES ARE DENSE AND UNIFORM: `Quotation withheld` Seven of the eight authors file a comparable statement, most naming Actelion. Every one is declared, none is hidden, and a task force that widens a disease boundary is advised by people paid by the manufacturers of its treatments - which is a fact about the field's structure, not an allegation about this paper Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | limitations[4] | 0.95 | the tagger's words |
| controls | requiring PAWP <=15 mmHg and PVR >=3 WU alongside the pressure, so that a raised mPAP counts only when it is resistance Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. eliminates: calling high cardiac output, a left-to-right shunt, left heart disease or hyperviscosity 'pulmonary vascular disease' · outcome: held | controls[0] | 0.95 | the tagger's words |
| controls | refusing to reintroduce exercise PH into the definition Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. eliminates: a criterion that separates the healthy from the ill but cannot say which disease, and that is 'impractical as a clinical routine' · outcome: held | controls[1] | 0.95 | the tagger's words |
| controls | stating that the new definition 'does not imply treating these additional patients' Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. eliminates: reading a widened diagnostic boundary as a widened treatment indication · outcome: partial | controls[2] | 0.95 | the tagger's words |
| controls | requiring robust data before any further reclassification, and applying that rule immediately by demoting splenectomy and thyroid disorders out of group 5 Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. eliminates: a classification that grows by plausibility · outcome: held | controls[3] | 0.95 | the tagger's words |
| concepts | pulmonary hypertension (PH) Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: pulmonary hypertension (PH) | concepts[0] | 0.95 | the paper's words |
| concepts | mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | concepts[1] | 0.95 | the paper's words |
| concepts | Pre-capillary PH Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: Pre-capillary PH | concepts[2] | 0.95 | the paper's words |
| concepts | mPAP >20 mmHg, PAWP ≤15 mmHg and PVR ≥3 WU Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | concepts[3] | 0.95 | the paper's words |
| concepts | PAP elevation Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: PAP elevation | concepts[4] | 0.95 | the paper's words |
| concepts | increase in cardiac output Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: increase in cardiac output | concepts[5] | 0.95 | the paper's words |
| concepts | LHD Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: LHD | concepts[6] | 0.95 | the paper's words |
| concepts | PVD Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: PVD | concepts[7] | 0.95 | the paper's words |
| concepts | PAH Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: PAH | concepts[8] | 0.95 | the paper's words |
| concepts | PVOD/PCH Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: PVOD/PCH | concepts[9] | 0.95 | the paper's words |
| concepts | group 5 Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: group 5 | concepts[10] | 0.95 | the paper's words |
| concepts | forms of PH with unclear and/or multifactorial mechanisms Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | concepts[11] | 0.95 | the paper's words |
| concepts | PAH with vasoreactivity Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: PAH with vasoreactivity | concepts[12] | 0.95 | the paper's words |
| concepts | IPAH Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: IPAH | concepts[13] | 0.95 | the paper's words |
| concepts | borderline mPAP Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: borderline mPAP | concepts[14] | 0.95 | the paper's words |
| concepts | mPAP ≤20 mmHg Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: mPAP ≤20 mmHg | concepts[15] | 0.95 | the paper's words |
| concepts | Definite association Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: Definite association | concepts[16] | 0.95 | the paper's words |
| concepts | drugs with data based on outbreaks, epidemiological case–control studies or large multicentre series Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | concepts[17] | 0.95 | the paper's words |
| senses | `pulmonary hypertension`, 1973-2018 sense - `mPAP >=25 mmHg at rest, measured by right heart catheterisation`, a value the defining meeting called `somewhat empirical and arbitrarily defined` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[0] | 0.95 | the tagger's words |
| senses | `pre-capillary PH`, 2018 sense - THREE conditions at once: `mPAP >20 mmHg, PAWP <=15 mmHg and PVR >=3 WU`. The second and third exist to say that the raised pressure is resistance and not flow or wedge Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[1] | 0.95 | the tagger's words |
| senses | `borderline PH` - mPAP 21-24 mmHg: the band between the old threshold and the new one, which had a name while it was outside the definition Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[2] | 0.95 | the tagger's words |
| senses | `exercise PH` - part of the definition in 2004 (`exercise mPAP >30 mmHg`), removed in 2008, reconsidered and refused in 2018 because exercise PAWP cannot be measured reliably enough to tell left heart disease from pulmonary vascular disease Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[3] | 0.95 | the tagger's words |
| senses | `group 5` - PH `with unclear and/or multifactorial mechanisms`; previously `disorders directly affecting the pulmonary vasculature` (1998) and `MISCELLANEOUS` (2003). The class of conditions we do not yet understand Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[4] | 0.95 | the tagger's words |
| senses | `definite` vs `possible` drug association - definite means `data based on outbreaks, epidemiological case-control studies or large multicentre series`; possible means `multiple case series`. A membership grade defined by STUDY DESIGN Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | senses[5] | 0.95 | the tagger's words |
| claim_relations | extends → the 1st WSPH definition of 1973 (mPAP >=25 mmHg) and its restatements at every WSPH from 1998 to 2013, which this task force replaces Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | claim_relations[0] | 0.95 | the tagger's words |
| claim_relations | extends → Kovacs et al.'s pooled analysis of 1187 normal subjects from 47 right-heart-catheterisation studies, from which the new threshold is derived Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | claim_relations[1] | 0.95 | the tagger's words |
| claim_relations | critiques → the use of a single pressure value as a diagnosis - 'this value used in isolation cannot characterise a clinical condition and does not define the pathological process per se' Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | claim_relations[2] | 0.95 | the tagger's words |
| claim_relations | critiques → the 2004 exercise criterion ('exercise mPAP >30 mmHg'), removed in 2008 and refused readmission here because exercise PAWP cannot distinguish left heart disease from pulmonary vascular disease Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | claim_relations[3] | 0.95 | the tagger's words |
| concept_edges | pulmonary hypertension (PH) —operationalised-as→ mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.95 · note: '(PH) HAS BEEN…' The adverb is the authors' own, in the first sentence of the abstract - and the 1973 report is quoted later saying the same thing about itself · the relation stated: from 1973 to this paper, having the disease meant having a catheter reading at or above 25 mmHg at rest - a number the defining meeting recorded as arbitrary
Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but the span says PH was ARBITRARILY defined this way and that the definition is now revised to >20 mmHg; superseded. | concept_edges[0] | 0.95 | the tagger's words |
| concept_edges | Pre-capillary PH —operationalised-as→ mPAP >20 mmHg, PAWP ≤15 mmHg and PVR ≥3 WU Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'Pre-capillary PH is best…' Lowering one threshold forced two more into the definition - because 'THIS VALUE USED…', and the further down the pressure scale you go the more true that is · the relation stated: the 2018 definition is a conjunction of three catheter measurements, two of them present only to prove that the raised pressure is resistance rather than flow | concept_edges[1] | 0.95 | the tagger's words |
| concept_edges | increase in cardiac output —causes→ PAP elevation Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.9 · note: 'PAP ELEVATION…' The edge runs from the cause to the reading, against the order of the sentence. This is the argument that forced PVR into the definition: a measurement with many causes cannot, alone, be a diagnosis · the relation stated: raised pulmonary pressure has several unrelated causes - high cardiac output, a shunt, raised wedge pressure, hyperviscosity - only one of which is vascular disease also in: increase in cardiac output · PAP elevation | concept_edges[2] | 0.95 | the tagger's words |
| concept_edges | forms of PH with unclear and/or multifactorial mechanisms —part-of→ group 5 Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.9 · note: `Since the basis of our classification system was established in 1998, group 5 has passed through significant changes. Initially describing `disorders directly affecting the pulmonary vasculature`, then named `MISCELLANEOUS` during the 3rd WSPH in 2003, and finally reaching its current presentation, this group includes forms of PH with unclear and/or multifactorial mechanisms.` The renaming across three meetings has no edge type in schema 0.3 - `renamed-across-fields` is false here, because it is one field renaming its own category over time. Filed in the open questions rather than forced into the nearest type · the relation stated: group 5 contains the conditions for which no predominant mechanism has been established - membership is a statement about the literature, not the patient | concept_edges[5] | 0.95 | the tagger's words |
| concept_edges | PAH with vasoreactivity —distinct-from→ IPAH Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'PAH with vasoreactivity was…' The subgroup is created because 'These results…'. A class created by treatment response and then corroborated molecularly - the reverse of the usual order, and the paper is candid that 'Pathophysiology of…' · the relation stated: long-term calcium-channel-blocker responders differ from idiopathic PAH in blood signature and gene variants as well as in prognosis, which is the case for making them a subgroup
Audit 2026-09-28: DOUBTFUL - read against its full span and kept, but attributed: the span reports what Hemnes and co-workers showed. also in: PAH with vasoreactivity · IPAH | concept_edges[6] | 0.95 | the tagger's words |
| concept_edges | borderline mPAP —contrasted-with→ mPAP ≤20 mmHg Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.95 · note: 'PATIENTS WITH SO-CALLED…' The comparison is between two bands of one continuous variable, and it is the only kind of evidence that can move a threshold: show that the excluded side already behaves like the included one · the relation stated: patients in the 21-24 mmHg band progressed to overt disease far more often than those below 20 mmHg - the empirical case that the old boundary was in the wrong place also in: borderline mPAP · mPAP ≤20 mmHg | concept_edges[7] | 0.95 | the tagger's words |
| concept_edges | drugs with data based on outbreaks, epidemiological case–control studies or large multicentre series —part-of→ Definite association Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. the relation itself is separately evidenced · strength of the relation: 0.9 · note: `'DEFINITE ASSOCIATION' INCLUDES DRUGS WITH DATA BASED ON OUTBREAKS, EPIDEMIOLOGICAL CASE-CONTROL STUDIES OR LARGE MULTICENTRE SERIES. 'POSSIBLE ASSOCIATION' is suggested by multiple case series or cases with drugs with similar mechanisms of action.` An evidential grade written into a classification - and note the asymmetry: mechanism similarity is enough for `possible` and never enough for `definite` · the relation stated: whether a drug is a definite or a possible cause of PAH is decided by the study design behind the association, not by the strength of the effect or a mechanism | concept_edges[8] | 0.95 | the tagger's words |
| content_tags | A 45-YEAR-OLD DIAGNOSTIC THRESHOLD LOWERED: `PH has been ARBITRARILY DEFINED as mPAP >=25 mmHg` -> `mPAP >20 mmHg ... This definition is, therefore, no longer arbitrary, but based on a scientific approach` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[0] | 0.95 | the tagger's words |
| content_tags | AND THE COMPANION CRITERION IS ADMITTED TO BE ARBITRARY IN THE SAME SECTION: `This cut-off value of PVR >=3 WU is also quite arbitrary ... In this sense, the use of a cut-off value of PVR >=3 WU IS CONSERVATIVE` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[1] | 0.95 | the tagger's words |
| content_tags | AND THE DEFINITION WAS HELD IN PLACE BY ITS CONSEQUENCES: `This definition REMAINED UNCHANGED during the subsequent WSPH meetings from 1998 to 2013, at least in part to preclude potential overdiagnosis and overtreatment of PH` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[2] | 0.95 | the tagger's words |
| content_tags | AND THE NEW NUMBER IS IN THE 1961 REPORT: WHO's Expert Committee said mPAP `does not normally exceed 15 mmHg ... and never exceeded 20 mmHg` - 57 years before the threshold moved to 20 Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[3] | 0.95 | the tagger's words |
| content_tags | the new definition does not imply treating the added patients; prospective trials must show whether they benefit Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[4] | 0.95 | the tagger's words |
| content_tags | total pulmonary resistance separated controls from LHD or PVD patients but could not distinguish LHD from PVD with confidence Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[5] | 0.95 | the tagger's words |
| content_tags | group 5 membership rests on the lack of robust data identifying predominant pathophysiological mechanisms Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[6] | 0.95 | the tagger's words |
| content_tags | splenectomy is better considered a risk factor for PH than a condition deserving its own classification Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[7] | 0.95 | the tagger's words |
| content_tags | AND A DISTINCTION WAS DISSOLVED INTO A SPECTRUM: `PAH and PVOD/PCH belong to a spectrum of PVDs rather than representing two clear-cut distinct entities` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[8] | 0.95 | the tagger's words |
| content_tags | AND A MEMBERSHIP GRADE IS MADE OF STUDY DESIGNS: `Definite association` requires `outbreaks, epidemiological case-control studies or large multicentre series`; `POSSIBLE` accepts `multiple case series` or a similar mechanism Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.findings[9] | 0.95 | the tagger's words |
| content_tags | `mPAP >=25 mmHg at rest, measured by right heart catheterisation` - `somewhat empirical and arbitrarily defined`, in the words of the meeting that set it Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: pulmonary hypertension | content_tags.definitions[0] | 0.95 | the tagger's words |
| content_tags | `the concomitant presence of mPAP >20 mmHg, PAWP <=15 mmHg and PVR >=3 WU` - three readings, all from one catheter Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: pre-capillary PH | content_tags.definitions[1] | 0.95 | the tagger's words |
| content_tags | `14.0+/-3.3 mmHg` in 1187 normal subjects, so `two standard deviations would suggest mPAP >20 mmHg ... above the 97.5th percentile` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: upper limit of normal mPAP | content_tags.definitions[2] | 0.95 | the tagger's words |
| content_tags | `a reduction of mPAP >=10 mmHg TO REACH an absolute value of mPAP <=40 mmHg with an increased or unchanged CO` - a change AND a level AND a third condition Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: acute vasodilator response | content_tags.definitions[3] | 0.95 | the tagger's words |
| content_tags | `the lack of robust data allowing a definite recognition of predominant pathophysiological mechanisms` - a criterion about the literature Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: group 5 | content_tags.definitions[4] | 0.95 | the tagger's words |
| content_tags | the 1973 value was `somewhat empirical and arbitrarily defined`; the new value is the 97.5th percentile of normal Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.quantities[0] | 0.95 | the tagger's words |
| content_tags | `this value was independent of sex and ethnicity, and was only slightly influenced by age and posture` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.quantities[1] | 0.95 | the tagger's words |
| content_tags | defended as `CONSERVATIVE, suggesting the presence of a MANIFEST pre-capillary PH` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.quantities[2] | 0.95 | the tagger's words |
| content_tags | `HR 3.7` against patients at mPAP <=20 mmHg; in a separate cohort, borderline PH carried `HR 2.37` for death against the lower-normal group Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.quantities[3] | 0.95 | the tagger's words |
| content_tags | the exercise rule of thumb that replaced it is `>=3 mmHg per litre of CO` in disease against `>=1` in normal subjects Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.quantities[4] | 0.95 | the tagger's words |
| content_tags | `Quotation withheld` 2.5% is a convention about how much of a healthy population to call abnormal. It is reproducible and auditable, which the 1973 number was not, and it is not a measurement of where disease begins Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.statistics[0] | 0.95 | the tagger's words |
| content_tags | `HR 3.7` for progression from the 21-24 mmHg band, `HR 2.37` (95% CI 1.14-4.97) for death in borderline PH against lower-normal, `HR 5.05` for manifest PH. The middle band sits between the two in every table - which is what a threshold in the wrong place looks like Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.statistics[1] | 0.95 | the tagger's words |
| content_tags | `the group with mPAP 21-24 mmHg had a median PVR of 2.7 WU and 36% of these patients had PVR >3 WU` - so the conjunctive definition admits about a third of the band, not all of it. The second criterion is what keeps the change from being a straight reclassification of everyone above 20 mmHg Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.statistics[2] | 0.95 | the tagger's words |
| content_tags | `PVR=(mPAP-PAWP)/CO` - a derived quantity, and the one that lets the definition say WHERE the pressure comes from. Its own threshold is `also quite arbitrary` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: pulmonary vascular resistance | content_tags.variables[0] | 0.95 | the tagger's words |
| content_tags | the term that separates pre- from post-capillary PH, and the measurement whose unreliability during exercise killed the exercise criterion Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. | content_tags.variables[1] | 0.95 | the tagger's words |
| content_tags | the instrument the whole definition is made of - and, the paper argues, the real remedy for overdiagnosis: `the main cause of overdiagnosis ... is the failure to confirm the diagnosis by RHC` Quotation withheld — this record is not cleared for redistribution. The sentence is in the paper at the link above. also in: right heart catheterisation (RHC) | content_tags.variables[2] | 0.95 | the tagger's words |
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What was deliberately not tagged, and why, is recorded per paper by the tagger. Where a paper has no such record, this page says so rather than implying that nothing was declined.