Outcomes Research in Cardiovascular Disease

Working Group Agenda

September 30, 2002

National Heart, Lung, and Blood Institute

Rockledge 2 building, Suite 9100/9104

6701 Rockledge Drive,

Bethesda, MD 20817

Chair: Harlan Krumholz, MD, Yale University

Vice-Chair: Eric Peterson, MD, Duke University

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8:00 - 8:15 AM

Welcome and introductions
Harlan Krumholz, MD, Yale University

8:15 - 8:30 AM

Charge to the Working Group
Denise Simons-Morton, MD, PhD, NHLBI

8:30 - 8:45 AM

Context and framework for the report
Harlan Krumholz, MD, Yale University

The goals of outcomes research are closely aligned with a number of important government initiatives currently underway which seek to improve health care. The Institute of Medicine released a blueprint for improving health care delivery entitled, Crossing The Quality Chasm: A New Health System For The 21st Century. This report identified safety, effectiveness, equity, efficiency, timeliness and patient-centeredness as the six core aims for improving the quality of care in the United States. The Working Group believes that these 6 aims can help define important targets for outcomes research in cardiovascular disease.

8:45-9:00 AM

Definitions and overview of Working Group activities to date
Harlan Krumholz, MD, Yale University

For the purposes of this Working Group, "Outcomes Research" is defined as applied clinical research that generates knowledge to improve clinical decision-making and health-care delivery to optimize patient outcomes. Outcomes Research focuses particularly on providing evidence to assess and promote the effectiveness of therapeutic interventions, to enhance the migration of best practice to clinical practice, to elevate the quality of care, and to support the optimal allocation of resources for all patients. The research has direct, proximate, and immediate relationships to patient care and health-care delivery. Research addresses not only patterns of care, but also elucidates factors contributing to those patterns, and determines their consequences. The research also is directed toward developing strategies to address current deficiencies in knowledge or implementation directly relevant to clinical practice. Outcomes Research can employ methodology of non-experimental (observational) designs, as well as quasi-experimental or clinical trial approaches to test interventions, whichever is most suited to the specific research question.

9:00 - 10:30 Subcommittee reports and discussion

  • Effectiveness
  • Catarina Kiefe, MD, University of Alabama
    Harlan Krumholz, MD, Yale University
  • Efficiency
  • William Weintraub, M.D., Emory University
    Lee Goldman, M.D., University of California SF
  • Equity
  • John Ayanian, M.D., Harvard Medical School
    Neil Powe, M.D., Johns Hopkins University

    10:30 - 10:45 Break

    10:45 - 12:15 Subcommittee reports and discussion (continued)

  • Patient-Centeredness
  • John Rumsfeld, M.D., Denver VA Medical Center
    John Spertus, M.D., Mid America Heart Institute
  • Timeliness
  • Marshall Chin, M.D., University of Chicago
    Robert DeBusk, M.D., Stanford University
  • Safety
  • Eric Peterson, MD, Duke University

    12:15 - 1:15 Lunch

    1:15 - 2:00 Future directions and priority setting

    2:00 - 2:30 Other Issues

  • Training
  • Mechanisms of support
  • Peer review/study sections
  • Existing datasets
  • Future workshops/Inter-agency collaborations
  • 2:30 - 3:30 Document discussion and priority setting

  • Prioritized future directions recommended to the NHLBI
  • Recommendations for investigators in the field (journal publication)
  • 3:30 - 4:00 Closing Remarks and Action Plans

    Planning Group

    Chair: Harlan Krumholz, M.D., Yale University School of Medicine
    Vice-Chair: Eric Peterson, M.D., Duke University
    Clinical Applications and Prevention Program, NHLBI staff:
    Denise Simons-Morton, M.D., Ph.D.
    Jeffrey Cutler, M.D., M.P.H.
    Marcel Salive, M.D., M.P.H.

    Working Group Members

    John Ayanian, M.D., Department of Health Care Policy, Harvard Medical School
    Diane Becker, R.N., Ph.D., Johns Hopkins School of Medicine
    Marshall Chin, M.D., University of Chicago
    Robert DeBusk, M.D., Stanford University
    Lee Goldman, M.D., University of California San Francisco
    Catarina Kiefe, M.D., University of Alabama at Birmingham
    Neil Powe, M.D., Johns Hopkins School of Medicine
    John Rumsfeld, M.D., Denver Veterans Affairs Medical Center
    John Spertus, M.D., Mid America Heart Institute
    William Weintraub, M.D., Emory University

    Representatives of other government agencies:

    George Mensah, M.D., National Center for Chronic Disease Prevention and Health Promotion, CDC
    Dan Stryer, M.D., Center for Outcomes and Effectiveness Research, AHRQ

    Posted: June 2004
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