Patient- and Family-Centered Care Recommendations in Cardiology Guidelines: An AI-Driven Systematic Review

Patient- and family-centred care (PFCC) is recognized as a critical component of cardiovascular care, but its integration into cardiology society guidelines has not been described. The objective of this study is to review PFCC language use and recommendations within major cardiology society guidelines.

We conducted a systematic review of guidelines and statements from the American College of Cardiology (ACC), the American Heart Association (AHA), the Canadian Cardiovascular Society (CCS), and the European Society of Cardiology (ESC) for the period 2013-2023. PFCC-related key terms were identified using an artificial intelligence-based natural language processing algorithm, and recommendations were categorized into 8 dimensions of PFCC. The inclusion of PFCC recommendations across societies and trends over time were examined.

A total of 260 guidelines and statements were analyzed. The most frequent PFCC dimensions overall were Health Transitions (23.5 per 100 pages), Shared Decision-Making (11.1 per 100 pages), and Care Access (9.9 per 100 pages). The least commonly identified dimensions across all journals were Care Coordination (6.5 per 100 pages), Emotional Support (4.0 per 100 pages), and Familial Support (1.0 per 100 pages). The CCS, ACC, and AHA had more recommendations using PFCC key terms than the ESC per 100 pages (17.3, 12.0, 10.3 vs 4.6, respectively, P < 0.01). PFCC language usage increased markedly over the 10-year period for the ACC, AHA, and ESC, but it decreased for the CCS (all P < 0.05).

PFCC language and recommendations are being included increasingly in cardiology society guidelines. Differences exist in PFCC language use across these societies. Future research is needed to evaluate the impact of these guideline recommendations on clinical practice.