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

描述(申请人提供)：在美国，三分之一的成年人患有心血管疾病，其治疗通常复杂、昂贵，很难持续提供高质量的治疗。我们的DCRI CERT的目标是在四种高度优先的心血管疾病中扩大循证治疗的知识和使用：房颤(AF)、急性冠脉综合征(ACS)、心力衰竭(HF)和高血压(HBP)。我们的建议解决了AHRQ的所有规划利益：安全性、比较有效性研究(CER)、工具开发、卫生系统干预以及转化为实践。为了实现我们的目标，我们与主要的简历专业协会、政府机构、支付者和药房福利经理建立了合作关系，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，我们建议研究国家CV护理，并开展一系列重要的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。这些重点是使用数据和反馈来让患者和提供者都参与进来。一旦得到证实，我们的干预措施是可持续的，并可以通过我们的简历协会合作伙伴在全国范围内传播。 我们的具体目标是： 1.为房颤、冠脉综合征、心力衰竭和高血压的研究创造新的国家“纵向数据平台”； 2.应用这些数据平台进行高质量的CER和安全研究，解决现有和 新出现的心血管疾病治疗问题； 3.设计和评估新的工具和实施战略，使患者和提供者能够 更有效、更安全、更高效地使用循证简历疗法； 4.与医学会、政府和其他合作伙伴合作，传播和维持这些 经证实最有效的干预措施； 5.与其他CERT中心和合作伙伴合作，推进研究方法，开展横向研究，培养下一代简历研究人员和领导者。 公共卫生相关性：我们的建议使用现有的大型临床、索赔和药房数据集来生成关于当前和新兴心血管疗法的相对安全性和有效性的新知识。我们还建议开发和评估几种患者和提供者教育和反馈工具，以提高全国范围内心血管护理的质量和一致性。

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.