Clinical Decision-Making for Heart Failure in Kosovo: A Conjoint Analysis

Area of Science:

• Cardiology
• Clinical Decision-Making
• Public Health

Background:

• Heart failure is a progressive, life-threatening condition.
• Early diagnosis and guideline adherence improve patient outcomes.
• Guideline adherence for heart failure is limited in Kosovo.

Purpose of the Study:

• To assess clinical decision-making for heart failure diagnosis.
• Evaluate physician preferences for clinical attributes in diagnosis.

Main Methods:

• Conjoint analysis utilized with 33 clinical scenarios.
• Study involved 14 physicians (internists and cardiologists).
• Conducted in two public hospitals in Kosovo.

Main Results:

• Age (60-69) and stable heart rate increased heart failure diagnosis likelihood.
• Edema, orthopnea, and fatigue decreased diagnosis likelihood.
• Specific examination findings like jugular venous pressure and elevated troponin/NTproBNP levels decreased diagnosis likelihood.

Conclusions:

• Significant variations in clinical signs influencing heart failure diagnosis were observed.
• Findings support quality improvement efforts and standardization of care.
• Study provides impetus for policy development in Kosovo's healthcare system.