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Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)

BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40–60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replac...

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Autores principales: Frey, Norbert, Steeds, Richard P., Serra, Antonio, Schulz, Eberhard, Baldus, Stephan, Lutz, Matthias, Pohlmann, Christiane, Kurucova, Jana, Bramlage, Peter, Messika-Zeitoun, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217261/
https://www.ncbi.nlm.nih.gov/pubmed/28056819
http://dx.doi.org/10.1186/s12872-016-0439-4
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author Frey, Norbert
Steeds, Richard P.
Serra, Antonio
Schulz, Eberhard
Baldus, Stephan
Lutz, Matthias
Pohlmann, Christiane
Kurucova, Jana
Bramlage, Peter
Messika-Zeitoun, David
author_facet Frey, Norbert
Steeds, Richard P.
Serra, Antonio
Schulz, Eberhard
Baldus, Stephan
Lutz, Matthias
Pohlmann, Christiane
Kurucova, Jana
Bramlage, Peter
Messika-Zeitoun, David
author_sort Frey, Norbert
collection PubMed
description BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40–60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment. METHODS/DESIGN: IMPULSE is a prospective, multicentre, European registry designed to gather data over 12 months on the treatment decisions made by referring physicians for patients newly diagnosed with severe AS. Each patient has a follow-up of 3 months. The study will consist of two observational phases to assess the appropriateness and rate of referral based on current guidelines prior to and after an interventional phase aiming to determine whether a simple quality of care intervention improves patient management. DISCUSSION: Data will be analysed firstly, to determine the appropriateness of treatment decisions for the management of severe AS in current European clinical practice, and secondly, to evaluate the effectiveness of facilitated data relay from a designated echocardiography department nurse to the referring physician early after diagnosis in improving quality of care. Additionally, variables will be identified that are associated with inappropriate decision-making. Collectively, the aim will be to design a clinical pathway that will improve the timely management of patients with newly diagnosed severe AS.
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spelling pubmed-52172612017-01-09 Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE) Frey, Norbert Steeds, Richard P. Serra, Antonio Schulz, Eberhard Baldus, Stephan Lutz, Matthias Pohlmann, Christiane Kurucova, Jana Bramlage, Peter Messika-Zeitoun, David BMC Cardiovasc Disord Study Protocol BACKGROUND: Severe aortic stenosis (AS) is a common, serious valve disease in which no effective medical therapy is available and, if not treated by intervention, has a 5-year survival of only 40–60%. Despite the availability of guidelines supporting the effective use of surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) to treat the majority of these patients, adherence to these guidelines in clinical practice is still unsatisfactory. Several recent studies have emphasised the necessity for improved communication between multidisciplinary teams, with the aim to ensure that severe AS patients receive appropriate treatment. METHODS/DESIGN: IMPULSE is a prospective, multicentre, European registry designed to gather data over 12 months on the treatment decisions made by referring physicians for patients newly diagnosed with severe AS. Each patient has a follow-up of 3 months. The study will consist of two observational phases to assess the appropriateness and rate of referral based on current guidelines prior to and after an interventional phase aiming to determine whether a simple quality of care intervention improves patient management. DISCUSSION: Data will be analysed firstly, to determine the appropriateness of treatment decisions for the management of severe AS in current European clinical practice, and secondly, to evaluate the effectiveness of facilitated data relay from a designated echocardiography department nurse to the referring physician early after diagnosis in improving quality of care. Additionally, variables will be identified that are associated with inappropriate decision-making. Collectively, the aim will be to design a clinical pathway that will improve the timely management of patients with newly diagnosed severe AS. BioMed Central 2017-01-05 /pmc/articles/PMC5217261/ /pubmed/28056819 http://dx.doi.org/10.1186/s12872-016-0439-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Study Protocol
Frey, Norbert
Steeds, Richard P.
Serra, Antonio
Schulz, Eberhard
Baldus, Stephan
Lutz, Matthias
Pohlmann, Christiane
Kurucova, Jana
Bramlage, Peter
Messika-Zeitoun, David
Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title_full Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title_fullStr Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title_full_unstemmed Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title_short Quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (IMPULSE)
title_sort quality of care assessment and improvement in aortic stenosis - rationale and design of a multicentre registry (impulse)
topic Study Protocol
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5217261/
https://www.ncbi.nlm.nih.gov/pubmed/28056819
http://dx.doi.org/10.1186/s12872-016-0439-4
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