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Hummel K, Whittaker S, Sillett N, Basken A, Berghammer M, Chalela T, Chauhan J, Garcia LA, Hasan B, Jenkins K, Ladak LA, Madsen N, March A, Pearson D, Schwartz SM, St Louis JD, van Beynum I, Verstappen A, Williams R, Zheleva B, Hom L, Martin GR. Development of an international standard set of clinical and patient-reported outcomes for children and adults with congenital heart disease: a report from the International Consortium for Health Outcomes Measurement Congenital Heart Disease Working Group. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2021; 7:354-365. [PMID: 33576374 DOI: 10.1093/ehjqcco/qcab009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/17/2021] [Accepted: 02/03/2021] [Indexed: 12/30/2022]
Abstract
AIMS Congenital heart disease (CHD) is the most common congenital malformation. Despite the worldwide burden to patient wellbeing and health system resource utilization, tracking of long-term outcomes is lacking, limiting the delivery and measurement of high-value care. To begin transitioning to value-based healthcare in CHD, the International Consortium for Health Outcomes Measurement aligned an international collaborative of CHD experts, patient representatives, and other stakeholders to construct a standard set of outcomes and risk-adjustment variables that are meaningful to patients. METHODS AND RESULTS The primary aim was to identify a minimum standard set of outcomes to be used by health systems worldwide. The methodological process included four key steps: (i) develop a working group representative of all CHD stakeholders; (ii) conduct extensive literature reviews to identify scope, outcomes of interest, tools used to measure outcomes, and case-mix adjustment variables; (iii) create the outcome set using a series of multi-round Delphi processes; and (iv) disseminate set worldwide. The Working Group established a 15-item outcome set, incorporating physical, mental, social, and overall health outcomes accompanied by tools for measurement and case-mix adjustment variables. Patients with any CHD diagnoses of all ages are included. Following an open review process, over 80% of patients and providers surveyed agreed with the set in its final form. CONCLUSION This is the first international development of a stakeholder-informed standard set of outcomes for CHD. It can serve as a first step for a lifespan outcomes measurement approach to guide benchmarking and improvement among health systems.
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Affiliation(s)
- Kevin Hummel
- Department of Pediatrics, University of Utah, Salt Lake City, UT, USA.,Department of Pediatric Cardiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
| | - Sarah Whittaker
- International Consortium for Health Outcomes Measurement, Cambridge, MA, USA
| | - Nick Sillett
- International Consortium for Health Outcomes Measurement, Cambridge, MA, USA
| | - Amy Basken
- Pediatric Congenital Heart Association, Madison, WI, USA.,Conquering CHD, Madison, WI, USA
| | - Malin Berghammer
- Queen Silvia Children Hospital/Sahlgrenska University Hospital, Gothenburg, Sweden.,University West, Trollhättan, Sweden
| | | | - Julie Chauhan
- All India Institute of Medical Sciences, New Delhi, India
| | | | - Babar Hasan
- Department of Pediatrics, Aga Khan University, Karachi City, Pakistan
| | - Kathy Jenkins
- Department of Pediatric Cardiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
| | - Laila Akbar Ladak
- Department of Pediatrics, Aga Khan University, Karachi City, Pakistan.,Susan Wakil School of Nursing, The University of Sydney, Sydney, Australia
| | - Nicolas Madsen
- Department of Cardiology, Cincinnati Children's Hospital, Cincinnati, OH, USA
| | | | - Disty Pearson
- Department of Pediatric Cardiology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, USA
| | - Steven M Schwartz
- Department of Cardiology, The Hospital for Sick Children, Toronto, ON, Canada
| | - James D St Louis
- Department of Surgery, Medical College of Georgia, Augusta, GA, USA
| | - Ingrid van Beynum
- Department of Pediatric Cardiology, Erasmus Medical Centre, Rotterdam, Netherlands.,Sophia Children's Hospital, Rotterdam, Netherlands
| | - Amy Verstappen
- Global Alliance for Rheumatic and Congenital Hearts, Philadelphia PA, USA
| | - Roberta Williams
- Department of Cardiology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | - Lisa Hom
- Department of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Gerard R Martin
- Department of Cardiology, Children's National Hospital, Washington, DC, USA
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Affiliation(s)
- Mardi Gomberg-Maitland
- From the Inova Heart and Vascular Institute, Virginia Commonwealth University, Falls Church (M.G.-M); and Pulmonary Department, Heart Institute, University of Sao Paulo Medical School, Brazil (R.S.)
| | - Rogerio Souza
- From the Inova Heart and Vascular Institute, Virginia Commonwealth University, Falls Church (M.G.-M); and Pulmonary Department, Heart Institute, University of Sao Paulo Medical School, Brazil (R.S.)
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Vener DF, Gaies M, Jacobs JP, Pasquali SK. Clinical Databases and Registries in Congenital and Pediatric Cardiac Surgery, Cardiology, Critical Care, and Anesthesiology Worldwide. World J Pediatr Congenit Heart Surg 2016; 8:77-87. [DOI: 10.1177/2150135116681730] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The growth in large-scale data management capabilities and the successful care of patients with congenital heart defects have coincidentally paralleled each other for the last three decades, and participation in multicenter congenital heart disease databases and registries is now a fundamental component of cardiac care. This manuscript attempts for the first time to consolidate in one location all of the relevant databases worldwide, including target populations, specialties, Web sites, and participation information. Since at least 1,992 cardiac surgeons and cardiologists began leveraging this burgeoning technology to create multi-institutional data collections addressing a variety of specialties within this field. Pediatric heart diseases are particularly well suited to this methodology because each individual care location has access to only a relatively limited number of diagnoses and procedures in any given calendar year. Combining multiple institutions data therefore allows for a far more accurate contemporaneous assessment of treatment modalities and adverse outcomes. Additionally, the data can be used to develop outcome benchmarks by which individual institutions can measure their progress against the field as a whole and focus quality improvement efforts in a more directed fashion, and there is increasing utilization combining clinical research efforts within existing data structures. Efforts are ongoing to support better collaboration and integration across data sets, to improve efficiency, further the utility of the data collection infrastructure and information collected, and to enhance return on investment for participating institutions.
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Affiliation(s)
- David F. Vener
- Department of Anesthesiology, Perioperative and Pain Medicine, Pediatric Cardiovascular Anesthesia, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Michael Gaies
- Department of Pediatric Cardiology, C. S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
| | - Jeffrey P. Jacobs
- Cardiovascular Surgery, Johns Hopkins All Children’s Hospital, St Petersburg, FL, USA
| | - Sara K. Pasquali
- Department of Pediatric Cardiology, C. S. Mott Children’s Hospital, University of Michigan, Ann Arbor, MI, USA
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