Development of a Cardiovascular Surveillance System in the CVRN

项目描述（由申请人提供）：本项目将为大约1100万HMO会员建立心血管疾病监测系统。该监测系统将首先针对冠心病（CHD）、心力衰竭（HF）和中风建立。这个项目的主要目标是：1。在国家心肺和血液研究所（NHLBI）资助的心血管疾病研究网络的15个中心建立冠心病（CHD）、心力衰竭（HF）和中风的监测系统，包括治疗干预措施、事件后结果和重要危险因素和混杂因素。2. 合作建立并实施一个汇总数据库，将来自所有15个CVRN站点的冠心病、心衰和卒中数据纳入其中，供CVRN研究者和其他合格的研究科学家用于开展与比较有效性和健康差异相关的研究。3. 确定冠心病、心力衰竭和中风临床结果的标准标准，以及目标#1中提到的所有组成部分，以实现数据汇总4。确定最近10年急性心肌梗死和卒中住院率的趋势及其与危险因素、合并症、治疗干预、药物和诊断方式趋势的关系。5. 证明这些数据可用于解决与监测健康差异的比较有效性和新方法有关的研究问题，这些领域已被国家卫生和社会福利部确定为RC2主题。该项目将形成一个由15个地理位置不同的健康计划组成的联盟的监测系统，为大约1100万人提供医疗保健，占美国人口的近4%。该监测系统将明显大于美国现有的其他心血管监测工作，并包括不同种族/民族和社会人口特征的人群。监测系统将包括冠心病、心衰和中风的电子数据，包括危险因素、合并症、处方药、治疗干预、实验室检测以及医生和患者特征。这些数据可用于及时提供冠心病、CF和脑卒中的监测报告；全面描述患者在冠心病、CF和中风发生前后的纵向病程；并使研究问题得以解决，以评估这些变量与疾病过程的关系，并解决与比较有效性和医疗治疗和结果差异有关的研究问题。

DESCRIPTION (provided by applicant): This project will establish a surveillance system for cardiovascular disease in approximately 11 million health maintenance organization (HMO) members. The surveillance system will be initially established for coronary heart disease (CHD), heart failure (HF), and stroke. The broad goals of this project are to: 1. Establish a surveillance system for coronary heart disease (CHD), heart failure (HF) and stroke in the 15 centers of the National Heart Lung and Blood Institute (NHLBI) funded Cardiovascular Disease Research Network including therapeutic interventions, post-event outcomes and important risk factors and confounders. 2. Work collaboratively to establish and implement an aggregate database incorporating coronary heart disease CHD, HF, and stroke data from all 15 CVRN sites that can be used by CVRN investigators and other qualified research scientists to conduct studies related to comparative effectiveness and health disparities. 3. Identify standard criteria for coronary heart disease, heart failure and stroke clinical outcomes, as well as all components noted in goal #1 to enable data aggregation 4. Determine the most recent 10-year trends in the rates of acute myocardial infarction and stroke hospitalization and their relationship to trends in risk factors, co-morbidities, therapeutic interventions, medications, and diagnostic modalities. 5. Demonstrate that the data can be used to address research questions regarding comparative effectiveness and novel methods of monitoring health disparities, areas that have been identified as RC2 topics by NHLBI. This project will result in a surveillance system in a consortium of 15 geographically diverse health plans that provide health care to about 11 million people, nearly 4% of the U.S. population. This surveillance system will be significantly larger than other existing cardiovascular surveillance efforts in the U.S. and includes a population that is diverse in race/ethnicity and sociodemographic characteristics. The surveillance system will include for CHD, HF, and stroke electronically available data on risk factors, co-morbidities, prescription medications, therapeutic interventions, and laboratory testing, and physician and patient characteristics. These data can be utilized to provide timely surveillance reports for CHD, CF, and stroke; a comprehensive description of a patient's longitudinal course both prior to and subsequent to development of CHD, CF, and stroke; and enable research questions to be addressed that assess the relationship of these variables to the course of disease as well as to address research questions relating to comparative effectiveness and to disparities in medical treatment and outcomes. PUBLIC HEALTH RELEVANCE: This project will establish a large database of information about heart disease and stroke in about 11 million members of 15 HMO providers of comprehensive medical care. This information will be used to examine patterns over time in the rates of heart disease and stroke, the first and third leading causes of death in the U.S. These data will enable the medical and public health community to assess progress over time in reducing the rate of these deadly and expensive diseases, to help identify interventions that are effective in preventing heart disease and stroke as well as interventions that favorably impact the lives of those who live with these conditions.