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Inclusion of Performance Parameters and Patient Context in the Clinical Practice Guidelines for Heart Failure

Parag Goyal1, Ozan Unlu1, Peter J Kennel1

  • 1Department of Medicine, Weill Cornell Medicine, New York, New York.

Journal of Cardiac Failure
|October 16, 2020
PubMed

Insights

Clinical practice guidelines for heart failure often omit crucial performance data and patient context. Enhancing these guidelines is vital for improving evidence-based medicine and patient-centered care.

Area of Science:

  • Cardiology
  • Clinical Practice Guidelines
  • Evidence-Based Medicine

Background:

  • Evidence-based medicine (EBM) requires individual-level data for effective clinical decision-making.
  • Clinical practice guidelines (CPGs) should ideally incorporate performance parameters and patient context to facilitate EBM.

Purpose of the Study:

  • To assess the extent to which current heart failure CPGs include diagnostic and therapeutic performance parameters.
  • To evaluate the incorporation of patient context in heart failure CPGs.

Main Methods:

  • Review of key heart failure CPGs: ACCF/AHA 2013, ACCF/AHA/HFSA 2017 update, and ESC 2016.
  • Abstraction of data on quality of evidence, strength of recommendation, performance parameters, and patient context for each CPG recommendation.

Main Results:

  • Performance parameters for diagnostic studies were rarely included (0-13%).
  • Performance parameters for therapeutic interventions were variably included (16-65%).
  • Patient context was included in approximately 25-50% of recommendations.

Conclusions:

  • Most heart failure CPGs lack essential performance parameters and patient context information.
  • Optimizing CPGs with comprehensive data is crucial for implementing EBM in heterogeneous heart failure populations.
  • Innovative strategies are needed to enhance CPGs for improved population outcomes and patient-centered care.
Abstract

Keywords:
Heart failuredecision-makingevidence-based medicine (EBM)practice guidelines

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