Development of a Cardiovascular Surveillance System in the CVRN

描述（由申请人提供）：该项目将在大约1100万健康维护组织（HMO）成员中建立心血管疾病监测系统。初步建立冠心病、心力衰竭、脑卒中监测系统。该项目的主要目标是：1。在国家心肺血液研究所（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）和卒中的监测系统，包括治疗干预、事件后结局和重要风险因素和混杂因素。 2.合作建立和实施一个综合数据库，该数据库包含来自所有15个CVRN研究中心的冠心病CHD、HF和卒中数据，CVRN研究者和其他合格的研究科学家可使用该数据库进行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局的标准标准，以及目标1中提到的所有组成部分，以实现数据汇总4。确定急性心肌梗死和卒中住院率的最近10年趋势及其与风险因素、合并症、治疗干预、药物和诊断方式趋势的关系。 5.证明数据可用于解决有关比较有效性和监测健康差距的新方法的研究问题，这些领域已被确定为NHLBI的RC 2主题。该项目将在15个地理位置不同的健康计划联盟中建立一个监测系统，为约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，并包括种族/民族和社会人口特征多样化的人群。监测系统将包括CHD、HF和卒中的电子可用数据，包括风险因素、合并症、处方药、治疗干预和实验室检查以及医生和患者特征。这些数据可用于提供CHD、CF和卒中的及时监测报告; CHD、CF和卒中发生之前和之后患者纵向病程的综合描述;并使研究问题得到解决，评估这些变量与疾病过程的关系，以及解决与比较有效性和差异有关的研究问题，医疗和结果。 公共卫生相关性：该项目将为15个HMO综合医疗保健提供者的约1100万成员建立一个关于心脏病和中风信息的大型数据库。这些信息将用于检查心脏病和中风的发病率随时间的变化模式，这是美国第一和第三大死亡原因，这些数据将使医疗和公共卫生界能够评估随着时间的推移在降低这些致命和昂贵疾病的发病率方面取得的进展。帮助确定有效预防心脏病和中风的干预措施，以及对这些患者的生活产生有利影响的干预措施。条件

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.