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At the very least, they should pay attention to the advice given in the article they cite in their report's footnote 15, which expressly states: "The use of breed-specific VHS values is needed for the VHS method to have a high specificity for normal heart size." We would prefer using a patient-specific VHS value, rather than just breed-specific, but either one is better than a reckless, species-wide "median" VHS value

Cruz-Pereira JS, Moloney GM, Bastiaanssen TFS, Boscaini S, Tofani G, Borras-Bisa J, et al

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