DETAILED ACTION Notice of Pre-AIA or AIA Status The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA. Election/Restrictions Claims 6-20 are withdrawn from further consideration pursuant to 37 CFR 1.142(b), as being drawn to a nonelected invention, there being no allowable generic or linking claim. Applicant timely traversed the restriction (election) requirement in the reply filed on November 22, 2025. Applicant's election with traverse of Inventions I , claims 1-5 in the reply filed on November 22, 2025 and as indicated by Applicant in the Interview Summary mailed on January 20, 2026 is acknowledged. The traversal is on the ground(s) that: All claims of Groups I and IV share a single general inventive concept in that they both are directed to evaluating chest pain in an emergency or acute setting, uses the same clinical inputs, produces the same type of output and addresses the same clinical problem of distinguishing low-risk chest pain from life-threatening conditions. The four groups are directed to species and not distinct inventions, wherein under MPEP 806.04(f), “[r] estriction is improper where species are linked by a substantial overlapping relationship” and Groups I and IV are not distinct because they describe the same triage method at different levels of detail All claim groups require the same field of search, specifically searching the same art units and same prior art classes, wherein the same prior art references would disclose both MI evaluation and PE evaluation. Examiner’s classification-based distinction is not a proper basis for restriction as the assignment to a different code does not mean the inventions are distinct. All claims rely on the same diagnostic steps, same data, same ML/algorithmic reasoning and deliver the same clinical utility, and thus all claims form one interrelated, non-distinct invention. This is not found persuasive because : As stated in MPEP 802.01, II and 802.02, restriction is the practice of requiring an applicant to elect a single claimed invention for examination when two or more independent and/ or two or more distinct invention s are claimed in an application. Further, two or more related inventions are distinct “if the inventions as claimed are not connected in at least one of design, operation, or effect and wherein at least one invention is PATENTABLE (novel and nonobvious) OVER THE OTHER (though they may each be unpatentable over the prior art ” . Though the groups may share some features, and thus are "related", the inv entions also do not share other features (i.e. see restriction requirement between Inventions I and IV, wherein the inventions as claimed have a materially different mode of operation and function) , thus rendering them "distinct" and subject to restriction . Additionally, Examiner respectfully disagrees with Applicant’s assertion that “every claim” of Groups I and IV is directed to evaluating chest pain in an emergency or acute setting, uses the same clinical inputs, produces the same type of output and addresses the same clinical problem of distinguishing low-risk chest pain from life-threatening conditions as Claim 1 and Claim 19 as claimed do not make any reference to performing an evaluation “in an emergency or acute setting”, nor do they use the same clinical inputs (i.e. claim 1 determines the first score from age and a troponin level, which claim 19 makes no mention of), produce the same type of output or address the same clinical problem ( i.e. claim 1 makes a recommendation associated with discharging a patient whereas claim 19 determines a pulmonary embolism (PE) risk) . As set forth in the restriction requirement mailed on 8/25/25, the restriction requirement between Groups I and IV is not setting forth a species restriction , but rather the restriction requirement sets forth that Groups I and IV are directed to “related processes”. As such, Applicant’s arguments directed to species is not persuasive to withdraw the restriction requirement. It is further noted that claims 1 and 19 do not have substantial overlapping relationship , as is clear in that, as claimed , they each disclose limitations that are not present in the other. Examiner respectfully disagrees that all claim groups require the same field of search . F or example, Claim 1 require s a patient presenting with chest pain and making a recommendation associated with discharging a patient based on the CAC score, etc., which claim 19 does not require and claim 19 requires vs. assessing a patient's risk of pulmonary embolism ( P E) and measuring the patient’s D-dimer, etc., which claim 1 does not require . These differences between the two groups would require the use of diffe rent search terms , etc., thus not requiring the same field of search. As set forth in the 8/25/25 Restriction Requirement, the distinctness between Groups I and IV is demonstrated in that they have a materially different mode of operation and function and thus the restriction is not solely based on classification differences. Examiner respectfully disagrees that all claims of Group I and IV rely on the same diagnostic steps, same data, same ML/algorithmic reasoning and deliver the same clinical utility. Specifically, Claim 1 and Claim 19 as claimed do not make any reference of using the same data (i.e. claim 1 determines the first score from age and a troponin level, which claim 19 makes no mention of) , delivering the same clinical utility (i.e. claim 1 makes a recommendation associated with discharging a patient whereas claim 19 determines a pulmonary embolism (PE) risk) , etc. The requirement is still deemed proper and is therefore made FINAL . Priority Applicant’s claim for the benefit of a prior-filed application under 35 U.S.C. 119(e) or under 35 U.S .C. 120, 121, 365(c), or 386(c) is acknowledged. Applicant has not complied with one or more conditions for receiving the benefit of an earlier filing date as follows: The later-filed application must be an application for a patent for an invention which is also disclosed in the prior application (the parent or original nonprovisional application or provisional application). The disclosure of the invention in the parent application and in the later-filed application must be sufficient to comply with the requirements of 35 U.S.C. 112(a) or the first paragraph of pre-AIA 35 U.S.C. 112, except for the best mode requirement. See Transco Products, Inc. v. Performance Contracting, Inc. , 38 F.3d 551, 32 USPQ2d 1077 (Fed. Cir. 1994). The disclosure of the prior-filed application s , Provisional Application No. 63/414,546 and Application No. 17/657,754 fail to provide adequate support or enablement in the manner provided by 35 U.S.C. 112(a) or pre-AIA 35 U.S.C. 112, first paragraph for one or more claims of this application. Specifically, the prior-filed application 17/657,754 does not provide support for obtaining a cardiovascular volumetry risk index associated with the patient and, based on the cardiovascular volumetry risk index, making a recommendation associated with discharging the patient and the Provisional application 63/414,546 does not provide support for determining a first score based at least in part on data associated with the age and a troponin level of the patient, if the first score is below a predetermined risk level, obtaining a CAC score and a volumetry risk index and making a recommendation associated with discharging the patient. As suc h, the effective filing date of the instant application is considered to be February 11, 2023, which is the filing date of the instant application. Claim Objections Claims 1 -4 are objected to because of the following informalities: In claim 1, in line 1, “the risk” should be changed to --- a risk ---. In claim 1, in line 3, “the age” should be changed to – an age ---. In claim 1, in line 5, “CAC” should be replaced with --- coronary artery calcium (CAC) ---. In claim 2, in line 1, “a first score” should be changed to --- the first score ---. In claim 3, in line 1, “a cardiovascular volumetry risk index” should be changed to – the cardiovascular volumetry risk index ---. In claim 4, in line 1, “an estimate” should be changed to --- the estimate ---. In claim 4, in line 1, --- the --- should be inserted before “left ventricle.. ”. Appropriate correction is required. Claim Rejections - 35 USC § 112 The following is a quotation of 35 U.S.C. 112(b): (b ) CONCLUSION.— The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the inventor or a joint inventor regards as the invention. The following is a quotation of 35 U.S.C. 112 (pre-AIA), second paragraph: The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the appl icant regards as his invention. Claim 5 is rejected under 35 U.S.C. 112(b) or 35 U.S.C. 112 (pre-AIA), second paragraph, as being indefinite for failing to particularly point out and distinctly claim the subject matter which the inventor or a joint inventor (or for applications subject to pre-AIA 35 U.S.C. 112, the applicant), regards as the invention. With regards to claim 5, in line 1, it is unclear as to whether “an AI enabled calculator” and, in line 2, “the AI enabled calculator” are referring to the --- artificial intelligence (AI) enabled volume calculator” as set forth in line 2 of claim 4, or referring to a different AI enabled calculator. For examination purposes, Examiner assumes the former. Claim Rejections - 35 USC § 101 35 U.S.C. 101 reads as follows: Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title. Claim s 1-5 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more. Claim 1 is directed to a method claim. Claim 1 recite(s) determining a first score based at least in part on data associated with the age and a troponin level of the patient, and based on the CAC score and the cardiovascular volumetry risk index, making a recommendation associated with discharging the patient. The limitations, as drafted, is a process that, under its broadest reasonable interpretation, covers performance of the limitations in the mind. That is, nothing in the claim element precludes the steps from practically being performed in the mind. For example, “determining a first score based at lest in part on data associated with the age and troponin level of the patient” in the context of the claim encompasses the user mentally assigning numerical values to the age and troponin level to mentally determine the first score and “based on the CAC score and the cardiovascular volumetry risk index, making a recommendation associated with discharging the patient, encompasses the user viewing the CAC score and the cardiovascular volumetry risk index on a screen and mentally deciding on the recommendation for discharge by comparing the CAC score and the volumetry risk index to thresholds/limits. If a claim limitation, under its broadest reasonable interpretation, covers performance of the limitation in the mind but for the recitation of generic computer components, then it falls within the “Mental Processes” grouping of abstract ideas. Accordingly, the claim recites an abstract idea. Th e judicial exception is not integrated into a practical applicatio n . In particular, the claim recites additional elements: “if the first score is below a predetermined risk level, obtaining a CAC score and a cardiovascular volumetry risk index associated with the patient”. This step is recited at a high level of generality (i.e. as a means for gathering/obtaining data for the other steps) and amounts to mere data gathering, which is a form of insignificant extra-solution activity. Accordingly, these additional elements do not integrate the abstract idea into a practical application because they do not impose meaningful limits on practicing the abstract idea. The claims are directed to an abstract idea . The claim(s) does/do not include additional elements that are sufficient to amount to significantly more than the judicial exception because the additional element of obtaining a CAC score and a cardiovascular volumetry risk index associated with the patient amounts to no more than insignificant extra-solution activity. Mere insignificant extra-solution activity cannot provide an inventive concept. The claims are not patent eligible. The dependent claims do not appear to be patent eligible as the dependent claims appear to be directed to insignificant extra-solution activity as they appear to be further limiting the steps of obtaining the first score and the cardiovascular volumetry risk index at a high level of generality (i.e. data-gathering means) [see claims 2-5]. Claim Rejections - 35 USC § 103 In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis ( i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status. The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action: A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made. Claim (s) 1 -5 is/are rejected under 35 U.S.C. 103 as being unpatentable over Mahler et al. (“The HEART Pathway Randomized Trial Identifying Emergency Department Patients With Acute Chest Pain for Early Discharge”, 2015) in view of Mortensen (“Coronary Artery Calcium in Acute Chest Pain Patients”, February 7, 2022) and Kay et al. (“ Identification of High-Risk Left Ventricular Hypertrophy on Calcium Scoring Cardiac Computed Tomography Scans Validation in the DHS ”, February 2020). With regards to claim 1, Mahler et al. disclose a method of expediting the risk assessment of a patient presenting with chest pain (Abstract, referring to the HEART pathway which is a decision aid to identify patients with acute chest pain for early discharge) , the method comprising: determining a first score (i.e. HEART score) based at least in part on data associated with the age and a troponin level of the patient (pg. 196, right column, “ HEART Pathway” section, referring to participants being risk stratified by using the HEART score and serial troponin measures, wherein the HEART score consists of 5 components: history, ECG, age , risk factors, and troponin ); Figure 1) ; if the first score is below a predetermined risk level, obtaining cardiac testing and imaging results (pg. 196, right column, last paragraph -pg. 197, left column 1 st paragraph , pg. 197, right column, last paragraph, referring to “On the basis of the HEART score and serial troponin results, the attending physicians received care recommendations according to the HEART pathway (Figure 1)”, wherein a HEART of 0-to 3 is consistent with a low-risk assessment and a score of >= 4 is consistent with a high-risk assessment, and therefore a low-risk assessment is determined if the HEART score is below the predetermined risk level of 4 and wherein, as depicted in the HEART pathway of Figure 1, for patients with low-risk HEART scores (i.e. HEART score < 4) and positive troponin results, cardiology consultation and cardiac imaging (i.e. coronary computed tomography angiography, etc.) is performed ; Figure 1; Table 3) . However, Mahler et al. do not specifically disclose tha t the method further comprises obtaining a CAC score and a cardiovascular volumetry risk index associated with the patient if the first score is below the predetermined risk level and, based on the CAC score and the cardiovascular volumetry risk index, making a recommendation associated with discharging the patient. Mortensen discloses that the assessment of coronary artery calcium (CAC) in the high-sensitivity troponin era can serve as a gatekeeper to identify a large group of patients with acute chest pain who have limited benefit of advanced diagnostic testing, allowing for more sensible use of resources (Abstract; pg. 282, right column, last paragraph). Specifically, if patients with a single episode of chest pain had an ECG taken, had measured cardiac troponins as well as CAC, most patients could quickly and safely be sent home/discharged without any further testing (pg. 282, right column, last paragraph). This is supported by finding that patients with CAC = 0 is a common finding in patients who have had an episode of acute chest pain but who have normal cardiac troponins (i.e. first score associated with troponin levels is below a predetermined risk level), wherein, among patients with CAC = 0, as many as 95% have no detectable CAD, strongly suggesting that chest pain patients without CAC are generally a low-risk group with good long-term prognosis (pg. 282, left column, last paragraph). CAC can thus serve as a gatekeeper that is able to identify a large group of patients in whom further diagnostic testing with, e . g . , coronary CTA , will be of limited value (Abstract; pg. 282, left column, last paragraph , note that CAC serves as a gatekeeper to identify patients that can be sent home/discharged ). Before the effective filing date of the claimed invention, it would have been obvious to one of ordinary skill in the art to modify the method of Mahler et al. to further comprise obtaining a CAC score associated with the patient if the first score is below the predetermined risk level and, based on the CAC score, making a recommendation associated with discharging the patien t, as taught by Mortensen, to identify a large group of patients with acute chest pain who have limited benefit of advanced diagnostic testing, allowing for more sensible use of resources (Abstract; pg. 282, right column, last paragraph) . However, the above combined references do not specifically disclose that, along with the obtained CAC score, a cardiovascular volumetry risk index associated with the patient is further obtained. Kay et al. disclose that phenotypic elements identifiable on imaging, such as left ventricular hypertrophy (LVH) and remodeling, can play a significant role in the identification of individuals at risk for future heart failure or death (Abstract; pg. 2, left column, 2 nd paragraph). Therefore, a screening method that could integrate the assessment of coronary artery calcium (CAC) scoring and left ventricular phenotypes would be highly desirable in preventative cardiac imaging (pg. 2, left column, 2 nd paragraph). Specifically, quantitative assessment of the left ventricular end-diastolic volume (i.e. cardiovascular volumetry risk index) and mass identified subgroups with increased risk for heart failure or cardiac death patients (pg. 7, left column, first paragraph). A comprehensive cardiovascular risk screening tool based on CAC-CT comprising of traditional calcium scoring and left ventricular hypertrophy (LVH) phenotyping could concurrently identify individuals at risk for future events related to both coronary syndromes and heart failure (pg. 9, left column, 2 nd paragraph). Before the effective filing date of the claimed invention, it would have been obvious to one of ordinary skill in the art to have, along with the obtained CAC score of the above combined references , a cardiovascular volumetry risk index associated with the patient be further obtained [and thus the recommendation associated with discharging the patient is further based on the cardiovascular volumetry risk index], as taught by Kay et al., in order to provide a comprehensive cardiovascular risk screening tool comprising of traditional calcium scoring and left ventricular hypertrophy (LVH) phenotyping that can concurrently identify individuals at risk for future events related to both coronary syndromes and heart failure (pg. 9, left column, 2nd paragraph). With regards to claim 2, Mahler et al. disclose that determining the first score comprises determining a HEART score (Abstract; pg. 196, right column, “Heart Pathway”, referring to the HEART score consisting of history, ECG, age, risk factors and troponin; Figure 1). With regards to claim 3, Kay et al. disclose that obtaining a cardiovascular volumetry risk index comprises obtaining an estimate of left ventricle volume (Abstract; pg. 3, right column, first paragraph, referring to the parameters obtained including left ventricle (LV) end-diastolic volume (LVEDV), LV end-systolic volume, LV stroke volume, and LV mass, etc.; pg. 7, left column, first paragraph ). With regards to claim 4, Kay et al. disclose obtaining an estimate of left ventricle volume comprises using an artificial intelligence (AI) enabled volume calculator (Abstract, referring to using automated adaptive atlas algorithm to segment the left ventricle on CAC-CT, extracting radiomics features from the volume of interest and using logistic regression models using different feature selection methods to predict high-risk LVH based on CAC-CT radiomics in a random training subset of 1587 participants ; pg. 2, right column-pg. 4, left column, 1 st paragraph , referring to the machine learning pipeline, which includes automatic segmentation of the heart and obtaining voxel volume measurements by the automatic CAC-CT). With regards to claim 5, Kay et al. disclose using an AI enabled calculator comprises using non-contrast enhanced CT scan images as input to the AI enabled calculator (Abstract; pg. 2, right column, 4 th full paragraph-pg. 4, left column, first paragraph, referring to the use of noncontrast -enhanced cardiac CT scans for the automatic segmentation of the heart). Conclusion The prior art made of record and not relied upon is considered pertinent to applicant's disclosure. Criqui et al. (“Coronary Artery Calcium Volume and Density: Potential Interactions and Overall Predictive Value: The Multi-Ethnic Study of Atherosclerosis”, August 2017) disclose that the coronary artery calcium (CAC) volume score (i.e. cardiovascular volumetry risk index) significantly improved prediction for cardiovascular disease (CVD) events, wherein the addition of CAC density to CAC volume further significantly improved the prediction of CVD events (Abstract; pg. 853, left column, 2 nd paragraph; pg. 853, right column, “Perspectives”). Grandhi et al. (“Coronary Calcium to Rule Out Obstructive Coronary Artery Disease in Patients with Acute Chest Pain”) discloses using CAC as an initial diagnostic tool to determine whether to discharge patients (Abstract; Figure 2). 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