Quality markers in cardiology: measures of outcomes and clinical practice—a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery

López‐Sendón, José‐Luis; González-Juanatey, José Ramón; Pinto, Fausto J.; Castillo, José; Badimón, Lina; Dalmau, Regina; Torrecilla, Esteban G.; Mínguez, José Ramón López; Maceira, Alicia M.; Pascual-Figal, Domingo A.; Moya-Prats, José Luis Pomar; Sionís, Alessandro; Zamorano, José Luís

doi:10.1093/eurheartj/ehv527

Cited by 15 publications

(6 citation statements)

References 182 publications

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“…121 The Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery has defined quality markers for clinical cardiology, cardiac imaging acute care, interventional cardiology, cardiac rehabilitation and cardiac surgery. 122 The proposed indicators for AMI are in line with the ACCA selection, but not precisely defined and limited to direct transfer for PCI and recording FMC to balloon time for STEMI patients, risk assessment, revascularisation for high risk patients and adherence to guidelines for discharge treatment. Several other European countries have successfully implemented large-scale population-based registries to collect information about the incidence, management and outcome of ACS, such as the Acute Myocardial Infarction and Unstable Angina in Switzerland (AMIS plus) registry, 123 the Italian BLITZ registry, 124 the PRIAMHO I and II 125 in Spain and in the Central and Eastern European countries.…”

Section: Discussionmentioning

confidence: 99%

Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association

Schiele

Gale

Bonnefoy

et al. 2016

European Heart Journal: Acute Cardiovascular Care

118

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Evaluation of quality of care is an integral part of modern healthcare, and has become an indispensable tool for health authorities, the public, the press and patients. However, measuring quality of care is difficult, because it is a multifactorial and multidimensional concept that cannot be estimated solely on the basis of patients' clinical outcomes. Thus, measuring the process of care through quality indicators (QIs) has become a widely used practice in this context. Other professional societies have published QIs for the evaluation of quality of care in the context of acute myocardial infarction (AMI), but no such indicators exist in Europe. In this context, the European Society of Cardiology (ESC) Acute Cardiovascular Care Association (ACCA) has reflected on the measurement of quality of care in the context of AMI (ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation myocardial infarction (NSTEMI)) and created a set of QIs, with a view to developing programmes to improve quality of care for the management of AMI across Europe. We present here the list of QIs defined by the ACCA, with explanations of the methodology used, scientific justification and reasons for the choice for each measure.

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Section: Discussionmentioning

confidence: 99%

Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association

Schiele

Gale

Bonnefoy

et al. 2016

European Heart Journal: Acute Cardiovascular Care

118

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“…To have 120 cases suitable for analysis, we have estimated that it is necessary to include a total of 144 patients. With this sample size, considering that mortality in the first year after a STEMI may be up to 5%, 55 and taking into account that we have observed 2.6% of incidence of recurrent non-fatal myocardial infarctions during this period in our patients (unpublished data), we will have 11 patients not completing the trial, leaving 133 patients. In addition, we estimate that up to 10% of these patients could give up the study for other reasons, then leading 120 patients for analysis.…”

Section: Methodsmentioning

confidence: 99%

Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial

et al. 2016

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Introduction Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. Methods and analysis The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial. 144 patients with anterior STEMI will be assigned to receive calcifediol 0.266 mg capsules (Hidroferol SGC)/15 days or placebo on a 2:1 basis during 12 months. Primary objective: to evaluate the effect of calcifediol on LV remodelling defined as an increase in LV end-diastolic volume ≥10% (MRI). Secondary objectives: change in LV end-diastolic and end-systolic volumes, ejection fraction, LV mass, diastolic function, sphericity index and size of fibrotic area; endothelial function; plasma levels of aminoterminal fragment of B-type natriuretic peptide, galectin-3 and monocyte chemoattractant protein-1; levels of calcidiol (VD metabolite) and other components of mineral metabolism (fibroblast growth factor-23 (FGF-23), the soluble form of its receptor klotho, parathormone and phosphate). Differences in the effect of VD will be investigated according to the plasma levels of FGF-23 and klotho. Treatment safety and tolerability will be assessed. This is the first study to evaluate the effect of VD on cardiac remodelling in patients with STEMI. Ethics and dissemination This trial has been approved by the corresponding Institutional Review Board (IRB) and National Competent Authority (Agencia Española de Medicamentos y Productos Sanitarios (AEMPS)). It will be conducted in accordance with good clinical practice (International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use - Good Clinical Practice (ICH-GCP)) requirements, ethical principles of the Declaration of Helsinki and national laws. The results will be submitted to indexed medical journals and national and international meetings. Trial registration number NCT02548364; Pre-results.

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“…The aim is to identify the used and recommended hospital VBHC quality measures, measurement practices, and tools, and to identify potential strategies for improving cardiovascular diseases and cancer care in order to provide evidence for hospital management systems on the recommended VBHC quality measurement practices. No similar reviews were found as the published literature on this topic reviewed quality measures for various medical conditions but did not focus on cardiovascular or cancer diseases [22][23][24][25][26], or did not focus on the VBHC context [22,[27][28][29][30].…”

Section: Introductionmentioning

confidence: 99%

Quality measurement for cardiovascular diseases and cancer in hospital value-based healthcare: a systematic review of the literature

Abdalla

Pavlova

Hussein

et al. 2022

BMC Health Serv Res

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Background This systematic literature review identifies hospital value-based healthcare quality measures, measurement practices, and tools, as well as potential strategies for improving cardiovascular diseases and cancer care. Methods A systematic search was carried out in the PubMed, Embase, CINAHL, and MEDLINE (OvidSP) databases. We included studies on quality measures in hospital value-based healthcare for cardiovascular diseases and cancer. Two reviewers independently screened titles and abstracts, conducted a full-text review of potentially relevant articles, assessed the quality of included studies, and extracted data thematically. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and four validated tools were used for methodological quality assessment. Results The search yielded 2860 publications. After screening the titles and abstracts, 60 articles were retrieved for full-text review. A total of 37 studies met our inclusion criteria. We found that standardized outcome sets with patient involvement were developed for some cardiovascular diseases and cancer. Despite the heterogeneity in outcome measures, there was consensus to include clinical outcomes on survival rate and disease control, disutility of care, and patient-reported outcome measures such as long-term quality of life. Conclusion Hospitals that developed value-based healthcare or are planning to do so can choose whether they prefer to implement the standardized outcomes step-by-step, collect additional measures, or develop their own set of measures. However, they need to ensure that their performance can be consistently compared to that of their peers and that they measure what prioritizes and maximizes value for their patients. Trial registration PROSPERO ID: CRD42021229763.

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Quality markers in cardiology: measures of outcomes and clinical practice—a perspective of the Spanish Society of Cardiology and of Thoracic and Cardiovascular Surgery

Cited by 15 publications

References 182 publications

Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association

Quality indicators for acute myocardial infarction: A position paper of the Acute Cardiovascular Care Association

Design and rationale of a multicentre, randomised, double-blind, placebo-controlled clinical trial to evaluate the effect of vitamin D on ventricular remodelling in patients with anterior myocardial infarction: the VITamin D in Acute Myocardial Infarction (VITDAMI) trial

Quality measurement for cardiovascular diseases and cancer in hospital value-based healthcare: a systematic review of the literature

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