Using Data to Drive Change in National CV Care: The Duke CERTS

描述（由申请人提供）：心血管（CV）疾病影响美国三分之一的成年人，其治疗通常复杂、昂贵且难以始终如一地提供高质量的服务。我们的DCRI CERTs的目标是扩大四种高优先级CV疾病的循证治疗的知识和使用：心房颤动（AF）；急性冠脉综合征；心力衰竭（HF）；和高血压（HBP）我们的提案涉及所有AHRQ的项目利益：安全性、比较有效性研究（CER）、工具开发、卫生系统干预和转化为实践。为了实现我们的目标，我们与主要的CV专业协会、政府机构、支付方和药房福利管理机构建立了合作关系，可以利用这些合作来创建和支持一个全国性的纵向数据平台。利用这一平台，我们拟开展全国心血管护理研究，开展一系列重要的CER和安全性研究。我们还建议开发、实施和评估新的质量改进工具。这些方法侧重于使用数据和反馈来吸引患者和提供者。一旦得到证实，我们的干预措施是可持续的，可以通过我们的CV协会合作伙伴在全国范围内传播。

DESCRIPTION (provided by applicant): Cardiovascular (CV) disease affects one in three adults in the US and its treatments are often complex, expensive, and difficult to consistently deliver with high quality. Our DCRI CERTs goals are to expand the knowledge and use of evidence-based therapeutics in four high-priority CV conditions: atrial fibrillation (AF); acute coronary syndrome (ACS); heart failure (HF); and high blood pressure (HBP). Our proposal addresses all of AHRQ's Programmatic Interests: safety, comparative effectiveness research (CER), tool development, health system intervention, and translation to practice. To achieve our goals, we have established collaborations with the major CV professional societies, governmental agencies, payers and pharmacy benefit managers that can be leveraged to create and support a national, longitudinal data platform. Using this platform, we propose to study national CV care and carry out a series of important CER and safety studies. We also propose to develop, implement, and evaluate novel quality improvement tools. These focus on using data and feedback to engage both patients and providers. Once proven, our interventions are sustainable and can be disseminated nationally via our CV society partners. Our Specific Aims are to: 1. Create novel national 'longitudinal data platforms' for the study of AF, ACS, HF, and HBP; 2. Apply these data platforms to conduct high quality CER and safety studies that address existing and emerging CV therapeutic issues; 3. Design and evaluate novel tools and implementation strategies to empower patients and providers to more effectively, safely and efficiently use evidence-based CV therapeutics; 4. Work with medical society, government, and other partners to disseminate and sustain those interventions found to be most effective; 5. Collaborate with other CERT centers and partners to advance research methodology, carry out crosscutting research, and train the next generation of CV researchers and leaders. PUBLIC HEALTH RELEVANCE: Our proposal uses existing large clinical, claims, and pharmacy datasets to generate new knowledge regarding the comparative safety and effectiveness of current and emerging CV therapeutics. We also propose to develop and evaluate several patient- and provider-education and feedback tools to improve the quality and consistency of cardiovascular care on a national scale.