在心血管器械生命周期中推进健康公平
Andre M Small1, Nathan W Watson1,2, Rishi K Wadhera2,3
1Department of Medicine, Brigham and Women's Hospital (A.M.S., N.W.W.), Harvard Medical School, Boston, MA.
Circulation. Cardiovascular quality and outcomes
|February 3, 2025
概括
心血管器械创新可能会加剧边缘化群体的健康差异. 解决整个器械生命周期的不平等问题对于改善干预心脏病的准入和结果至关重要.
科学领域:
- 心血管医学 心血管医学
- 健康 公平 卫生 公平
- 医疗设备创新 医疗设备创新
背景情况:
- 尽管取得了进展,心血管疾病 (CVD) 护理差异仍然存在于边缘化人口中,包括种族/民族少数群体,妇女和农村居民.
- 透管心血管干预已经改善了治疗,但对于高负担人口来说,获取和结果仍然不公平.
- 心血管设备创新在延续这些差异方面的作用被低估了.
研究的目的:
- 检查心血管器械创新如何影响干预性心脏病学的健康差异.
- 利用心血管设备生命周期作为理解和减轻不平等的框架.
- 通过识别器械监管,试验,采用和结果的差异机制,为目标干预提供信息.
主要方法:
- 对心血管器械生命周期的叙述性审查.
- 对监管和审批流程的分析.
- 检查临床试验多样性和评估.
- 评估设备采用模式和程序后的结果.
- 专注于干预性心脏病学的例子.
主要成果:
- 心血管设备的创新和采用可能会无意中加剧现有的健康差异.
- 在临床试验代表性和公平获得新型干预措施方面存在差距.
- 监管和市场后监管可能无法充分解决公平性问题.
结论:
- 需要采取系统的方法,以确保心血管设备创新促进健康公平.
- 针对整个设备生命周期的干预措施是必要的,以减少干预心脏病学的差异.
- 监管机构,行业和临床医生之间的合作可以促进公平的获取和结果.
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