Journal:Heart failure and healthcare informatics
| Full article title | Heart failure and healthcare informatics |
|---|---|
| Journal | PLOS Medicine |
| Author(s) | Anwar, Mohamed S.; Japp, Alan G.; Mills, Nicholas L. |
| Author affiliation(s) | BHF Centre for Cardiovascular Science at University of Edinburgh |
| Primary contact | Email: nick dot mills at ed dot ac dot uk |
| Year published | 2019 |
| Volume and issue | 16 (5) |
| Page(s) | e1002806 |
| DOI | 10.1371/journal.pmed.1002806 |
| ISSN | 1549-1676 |
| Distribution license | Creative Commons Attribution 4.0 International |
| Website | https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002806 |
| Download | https://journals.plos.org/plosmedicine/article/file?id=10.1371/journal.pmed.1002806&type=printable (PDF) |
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Introduction
As biomedical research expands our armory of effective, evidence-based therapies, there is a corresponding need for high-quality implementation science—the study of strategies to integrate and embed research advances into clinical practice.[1] Large-scale collection and analysis of routinely collected healthcare data may facilitate this in three main ways. Firstly, evaluation of key healthcare metrics can help to identify the areas of practice that differ most from guideline recommendations. Secondly, with sufficiently granular data, it may be possible to detect the underlying drivers of deficiencies in practice. Thirdly, longitudinal data collection should enable us to evaluate large-scale policy initiatives and compare the effectiveness of differing strategies on process and patient outcomes.
Clinical practice and evidence-based management of heart failure
Heart failure, perhaps more than any other condition, exemplifies the potential for healthcare informatics to bridge the gap between practice and evidence-based care. The prevalence of heart failure is already estimated at one to two percent and is increasing with our ageing population.[2] Indeed, recent work has demonstrated that incident heart failure cases exceed the four most common causes of cancer combined in the United Kingdom.[3] Moreover, decompensated heart failure accounts for up to five percent of all acute unscheduled hospital admissions and has the longest length of stay of any cardiac condition.[4][5] Given the high rates of debilitating symptoms and death associated with heart failure, this burden to both patients and healthcare systems provides a moral and financial imperative to ensure optimal delivery of proven therapies. The treatment of chronic heart failure has one of the most robust evidence bases in clinical medicine, with multiple landmark trials leading to comprehensive guidelines.[6][7] Yet, despite effective therapies for heart failure being widely available, there is ample evidence to suggest a significant gap exists between guideline-directed practice and clinical practice.[8][9][10]
References
- ↑ Bauer, M.S.; Damschroder, L.; Hagedorn, H. et al. (2015). "An introduction to implementation science for the non-specialist". BMC Psychology 3: 32. doi:10.1186/s40359-015-0089-9. PMC PMC4573926. PMID 26376626. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4573926.
- ↑ Mosterd, A.; Hoes, A.W. (2007). "Clinical epidemiology of heart failure". Heart 93 (9): 1137–46. doi:10.1136/hrt.2003.025270. PMC PMC1955040. PMID 17699180. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955040.
- ↑ Conrad, N.; Judge, A.; Tran, J. et al. (2018). "Temporal trends and patterns in heart failure incidence: A population-based study of four million individuals". Lancet 391 (10120): 572–580. doi:10.1016/S0140-6736(17)32520-5. PMC PMC5814791. PMID 29174292. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5814791.
- ↑ British Heart Foundation (2019). "Heart statistics". https://www.bhf.org.uk/what-we-do/our-research/heart-statistics. Retrieved 13 March 2019.
- ↑ Berry, C.; Murdoch, D.R.; McMurray, J.J. (2001). "Economics of chronic heart failure". European Journal of Heart Failure 3 (3): 283–91. doi:10.1016/s1388-9842(01)00123-4. PMID 11377998.
- ↑ Ponikowski, P.; Voors, A.A.; Anker, S.D. et al. (2016). "2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC". European Journal of Heart Failure 18 (8): 891–975. doi:10.1002/ejhf.592. PMID 27207191.
- ↑ National Institute for Health and Care Excellence (2014). "Acute Heart Failure: Diagnosing and Managing Acute Heart Failure in Adults". NICE Clinical Guidelines, No. 187. National Clinical Guideline Centre. PMID 25340219. https://www.ncbi.nlm.nih.gov/books/NBK248063/.
- ↑ Cleland, J.G.; Cohen-Solal, A.; Aguilar, J.C.; et al. (2002). "Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme): An international survey". The Lancet 360 (9346): 1631–9. doi:10.1016/s0140-6736(02)11601-1. PMID 12457785.
- ↑ Teng, T.K.; Tromp, J.; Tay, W.T. et al. (2018). "Prescribing patterns of evidence-based heart failure pharmacotherapy and outcomes in the ASIAN-HF registry: A cohort study". The Lancet Global Health 6 (9): e1008–e1018. doi:10.1016/S2214-109X(18)30306-1. PMID 30103979.
- ↑ Butler, J.; Yang, M.; Manzi, M.A. et al. (2019). "Clinical Course of Patients With Worsening Heart Failure With Reduced Ejection Fraction". Journal of the American College of Cardiology 73 (8): 935–44. doi:10.1016/j.jacc.2018.11.049. PMID 30819362.
Notes
This presentation is faithful to the original, with only a few minor changes to presentation. Additional citation information such as PMID was provided when missing.
