1. Defining and Measuring a Standard Set of Patient Relevant Outcomes in Coronary Artery Disease
- Author
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Paul B. van der Nat, Matthijs Bax, Benno J. Rensing, Marijke J. C. Timmermans, A.O. Kraaijeveld, P. Rademaker, Victor A. Umans, Luc Noyez, M. van der Ent, T.W. Waterbolk, J. Haenen, S Houterman, Kevin Vernooy, J. M. van Opstal, Edgar J. Daeter, Dennis van Veghel, Tjebbe W. Galema, A. H. M. van Straten, G. Amoroso, W.J. van Boven, Jan-Henk E. Dambrink, J. Vos, M. Magro, S.L. Brinckman, S. de la Fuente, Alexander Hirsch, E Lipsic, S. Aydin, Cardiology, ACS - Heart failure & arrhythmias, Cardiothoracic Surgery, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
Male ,Multivariate analysis ,medicine.medical_treatment ,Health Status ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Psychological intervention ,Coronary Artery Disease ,Kaplan-Meier Estimate ,030204 cardiovascular system & hematology ,Conservative Treatment ,Outcome (game theory) ,Coronary artery disease ,0302 clinical medicine ,Postoperative Complications ,Quality of life ,EUROSCORE ,030212 general & internal medicine ,Coronary Artery Bypass ,Netherlands ,DEATH ,Middle Aged ,Survival Rate ,Mental Health ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,medicine.medical_specialty ,MEDLINE ,QUESTIONNAIRE ,03 medical and health sciences ,Percutaneous Coronary Intervention ,Internal medicine ,medicine ,Journal Article ,Humans ,Surgical Wound Infection ,Intensive care medicine ,Set (psychology) ,Aged ,Proportional Hazards Models ,business.industry ,MORTALITY ,Percutaneous coronary intervention ,medicine.disease ,Patient Outcome Assessment ,Logistic Models ,HEALTH-CARE ,Multivariate Analysis ,Quality of Life ,business - Abstract
Systematic outcome measurement enables to continuously improve treatment results and stimulates dissemination of best practices. For patients with coronary artery disease, no examples yet exist of standard sets of patient-relevant outcome measures that have already been fully implemented at a large scale in clinical care. The aim of this paper is twofold: (1) to share the standard set of outcome measures as developed by Meetbaar Beter, and (2) to show how the standard set is presented and published to support improvement of cardiac care. A step-wise approach was followed by an expert panel to construct a standard set of outcome measures. This resulted in a comprehensive set of relevant outcome measures, comprising 4 generic and 11 treatment-specific outcomes. Both short-term and long-term outcomes measures up to 5 years of follow-up were included. Relevant initial conditions were selected to enable case-mix adjustment. The standard set has been implemented in 21 hospitals across the Netherlands. The results and experiences have been used to finetune the set in 4 reporting cycles in 2012 to 2016, using an annual maintenance cycle. Currently about 83,000 percutaneous coronary interventions and 30,000 coronary artery bypass graftings are included in the dataset, covering the majority of all percutaneous coronary interventions and coronary artery bypass graftings in the Netherlands. In conclusion, Meetbaar Beter has defined and implemented a comprehensive set of patient-relevant outcome measures for coronary artery disease, and the variation of the results among the centers indicates that there are sufficient opportunities to further improve cardiac care in the Netherlands. (C) 2018 Elsevier Inc. All rights reserved.
- Published
- 2018