Duke Cardiovascular CERTs

描述：（由申请人提供）：心血管（CV）疾病仍然是美国最致命的疾病，而心血管护理仍然远非理想，心血管护理费用也是最昂贵的。许多心血管药物和设备的安全性和有效性在某些患者群体和社区环境中是不确定的，并且有充分的证据表明这些药物的使用不足，过度和滥用。为了解决这些问题，杜克临床研究所（DCRI）与所有主要的心血管专业协会建立了广泛的联盟。这些合作为我们提供了一个前所未有的机会来评估“现实世界”的心血管疗法的安全性、有效性和效率，同时也为我们提供了将所获得的知识转化为实践的手段；最终目标是在全国范围内改善患者的治疗效果。我们的提案还涉及了跨连续体的CV治疗；从住院患者设置到长期患者依从性问题；以及五个CV重点领域，包括：急性冠状动脉综合征；心力衰竭;中风;心源性猝死；冠状动脉血管重建术。该提案致力于推进上市后心血管药物和器械评估和质量改进的科学现状，同时也为临床医生、政策制定者和公众提供实用和可操作的信息和产品。我们杜克大学cert的具体目标是：

DESCRIPTION: (Provided by the Applicant): Cardiovascular (CV) disease remains the nation's #1 deadliest medical condition while CV care remains far from ideal and CV care costs are among the most expensive. The safety and effectiveness of many CV drugs and devices are uncertain in certain patient populations and in community settings, and there is ample evidence of under-, over- and mis-use of such agents. To address these issues, the Duke Clinical Research Institute (DCRI) has established a broad set of alliances with all of the major CV professional societies. These collaborations provide us with an unprecedented opportunity to evaluate 'real world' safety, effectiveness and efficiency of CV therapeutics, but also the means to translate knowledge gained into practice; with an ultimate goal of improving patient outcomes on a national scale. Our proposal also addresses CV therapeutics across the continuum; from in-patient settings to issues of long-term patient adherence; and for five major CV emphasis areas including: acute coronary syndromes; heart failure; stroke; sudden cardiac death; and coronary revascularization. This proposal is dedicated to advancing the state of the science of post-market CV drug and device evaluation and quality improvement, but also to generating practical and actionable information and products for clinicians, policy makers, and the public. Our Duke CERTs Specific Aims are to: 1. Promote the optimization of professional society-led CV registries as national surveillance systems for evaluating and assuring the safety and effectiveness of CV therapeutics and devices in community based settings; and meeting the informational needs of FDA, CMS, NIH, and AHRQ. 2. Identify specific barriers to both the translation of CV therapeutic and device evidence into routine clinical practice and long-term patient adherence to effective CV therapeutics. 3. Develop and rigorously evaluate patient- and provider-based interventions designed to improve the safe, effective, and efficient use of CV therapies and to improve long-term treatment adherence. 4. Widely disseminate those interventions found to be effective. 5. Train the next generation of CV outcomes researchers.