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Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology
Sherry-Ann Brown1,2, Abdulaziz Hamid3, Erin Pederson3
1Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. shbrown@mcw.edu.
Insights
A new rules-based tool helps clinicians implement cardiovascular disease prevention guidelines for cancer survivors. This aims to improve the use of medications and imaging, reducing risks for this vulnerable population.
Area of Science:
- Cardiology
- Oncology
- Medical Informatics
Background:
- Cancer survivors face increased risk of cardiovascular diseases, a major cause of death.
- Limited tools exist to implement cardiology guidelines for preventing cardiovascular disease (ASCVD) in survivors.
- Underutilization of cardiovascular medications, including statins, is common in this population.
Purpose of the Study:
- To develop a rules-based tool for point-of-care cardiovascular disease prevention in cancer survivors.
- To consolidate and streamline existing cardiology guidelines, consensus recommendations, and scientific statements.
Main Methods:
- Leveraged published guidelines, expert consensus, and scientific statements.
- Eliminated overlap, redundancy, and ambiguity across sources.
- Developed a rules-based system and assessed its integrity with use cases.
Main Results:
- Selected 7 key guidelines and statements after initial review of 10.
- Translated recommendations into actionable rules and proposed measures.
- Validated patient suitability and care suggestions using case examples.
Conclusions:
- A rules-based application was created to deliver cardiovascular disease prevention recommendations.
- This tool may enhance guideline implementation in clinical practice for cancer survivors.
- Potential to improve cardiovascular care across clinics, payers, and health systems.
Background:
Millions of cancer survivors are at risk of cardiovascular diseases, a leading cause of morbidity and mortality. Tools to potentially facilitate implementation of cardiology guidelines, consensus recommendations, and scientific statements to prevent atherosclerotic cardiovascular disease (ASCVD) and other cardiovascular diseases are limited. Thus, inadequate utilization of cardiovascular medications and imaging is widespread, including significantly lower rates of statin use among cancer survivors for whom statin therapy is indicated.
Methods:
In this methodological study, we leveraged published guidelines documents to create a rules-based tool to include guidelines, expert consensus, and medical society scientific statements relevant to point of care cardiovascular disease prevention in the cardiovascular care of cancer survivors. Any overlap, redundancy, or ambiguous recommendations were identified and eliminated across all converted sources of knowledge. The integrity of the tool was assessed with use case examples and review of subsequent care suggestions.
Results:
An initial selection of 10 guidelines, expert consensus, and medical society scientific statements was made for this study. Then 7 were kept owing to overlap and revisions in society recommendations over recent years. Extensive formulae were employed to translate the recommendations of 7 selected guidelines into rules and proposed action measures. Patient suitability and care suggestions were assessed for several use case examples.
Conclusion:
A simple rules-based application was designed to provide a potential format to deliver critical cardiovascular disease best-practice prevention recommendations at the point of care for cancer survivors. A version of this tool may potentially facilitate implementing these guidelines across clinics, payers, and health systems for preventing cardiovascular diseases in cancer survivors.
Trial Registration:
ClinicalTrials.Gov Identifier: NCT05377320.
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