Contextualizing Genetics for Regional Heart Failure Care

Iyngkaran, Pupalan; Thomas, Merlin C.; Johnson, Renée; French, John; Ilton, Marcus; McDonald, Peter J.; Hare, David L.; Fatkin, Diane

doi:10.2174/1573403x12666160606123103

Cited by 8 publications

(6 citation statements)

References 128 publications

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“…pseudo-randomisation techniques such as regression adjustment, propensity matching, inverse probability weighting and instrument variables to name a few could be explored [ 89 ]. Medical genetics could also be important [ 154 ].…”

Section: Developing Evidence For a New Treatment Strategymentioning

confidence: 99%

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

Iyngkaran

Kangaharan²,

Zimmet³

et al. 2016

CCR

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Chronic heart failure (CHF) among Aboriginal/Indigenous Australians is endemic. There are also grave concerns for outcomes once acquired. This point is compounded by a lack of prospective and objective studies to plan care. To capture the essence of the presented topic it is essential to broadly understand Indigenous health. Key words such as ‘worsening’, ‘gaps’, ‘need to do more’, ‘poorly studied’, or ‘future studies should inform’ occur frequently in contrast to CHF research for almost all other groups. This narrative styled opinion piece attempts to discuss future directions for CHF care for Indigenous Australians. We provide a synopsis of the problem, highlight the treatment gaps, and define the impediments that present hurdles in optimising CHF care for Indigenous Australians.

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Section: Developing Evidence For a New Treatment Strategymentioning

confidence: 99%

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

Iyngkaran

Kangaharan²,

Zimmet³

et al. 2016

CCR

Self Cite

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“…This was then confirmed in A-HEFT study [27]. Additional studies with ethnographic differentials were noted in blood pressure trial using diuretics and several renin aldosterone modulating agents inopril and losartan [28][29][30]. Moreover, epidemiological studies in African Amer…”

Section: Incidental Post-trial Population-level Patient Factors In Co...mentioning

confidence: 72%

Burden from Study Questionnaire on Patient Fatigue in Qualitative Congestive Heart Failure Research

Iyngkaran,

Usmani,

Bahmani

et al. 2024

JCDD

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Mixed methods research forms the backbone of translational research methodologies. Qualitative research and subjective data lead to hypothesis generation and ideas that are then proven via quantitative methodologies and gathering objective data. In this vein, clinical trials that generate subjective data may have limitations, when they are not followed through with quantitative data, in terms of their ability to be considered gold standard evidence and inform guidelines and clinical management. However, since many research methods utilise qualitative tools, an initial factor is that such tools can create a burden on patients and researchers. In addition, the quantity of data and its storage contributes to noise and quality issues for its primary and post hoc use. This paper discusses the issue of the burden of subjective data collected and fatigue in the context of congestive heart failure (CHF) research. The CHF population has a high baseline morbidity, so no doubt the focus should be on the content; however, the lengths of the instruments are a product of their vigorous validation processes. Nonetheless, as an important source of hypothesis generation, if a choice of follow-up qualitative assessment is required for a clinical trial, shorter versions of the questionnaire should be used, without compromising the data collection requirements; otherwise, we need to invest in this area and find suitable solutions

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“…Beyond pathophysiology compatibility, e.g. , pill size, dosing intervals, combinations, broader effects on comorbidities and a rigid formulary, [ 61 , 62 ] are not compatible with the evidence. In today's environment, stronger scientific foundations are more likely to influence rigid clinical practice [ 18 ].…”

Section: Building a Step-lock Research Translation And Cost-effective...mentioning

confidence: 99%

The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation

Iyngkaran

Hespe

Hanna

et al. 2023

CCR

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Background: Heart failure (CHF) is predominately a chronic disease. There are overlaps in HF and chronic disease research and care. Chronic disease and HF research is conducted with multiple goals. The overarching goal is “optimized patient outcomes at maximum cost-effectiveness”. Observations and patients, however, can come with many variables; thus, we see gaps in clinical translation. This document discusses an argument for three important gaps common to HF and chronic disease, i.e., screening, self-management, and patient-reported outcomes (PRO), and provides a glance of how it could fit into the evidence tree with a focus. Pertinent arguments for a framework for health services and models of care are provided as a prelude to future consensus. Methodology: 1) A preliminary literature review to identify a taxonomy for cardiovascular research and 2) a review of the published literature describing the translation of research studies into clinical practice for cardiovascular disorders. We identified a spectrum from observational to large randomized controlled trials to post-marketing studies. Results and Discussion: Research design in context to the above gaps are discussed.We then propose 6 steps to facilitate this: 1) Research design; 2) Research application (translation) i. routine ii. challenges; 3. Transforming research to translational level; 4. Funding and infrastructure; 5. CCRE and collaboration; 6. Governance and cost-efficacy. Conclusion: 1. Implementation research is a neglected area that aims to link research findings to improved patient outcomes, in an efficient and effective way. 2. Skills required to perform implementation research include a complex interplay of factors. 3. Ways to maximize translational impacts for chronic disease research to clinical practice are described in a CHF context.

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Contextualizing Genetics for Regional Heart Failure Care

Cited by 8 publications

References 128 publications

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

Heart Failure in Minority Populations - Impediments to Optimal Treatment in Australian Aborigines

Burden from Study Questionnaire on Patient Fatigue in Qualitative Congestive Heart Failure Research

The Wider Considerations in Closing Chronic Disease Gaps – Focus on Heart Failure and Implementation

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