Cardiol / Cardiothor Surg

Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: prevalence and incidence – AIHW – 19 November 2014

Posted on November 20, 2014. Filed under: Cardiol / Cardiothor Surg, Diabetes, Health Status, Nephrology | Tags: |

Cardiovascular disease, diabetes and chronic kidney disease: Australian facts: prevalence and incidence – AIHW – 19 November 2014

“Cardiovascular disease, diabetes and chronic kidney disease—Australian facts is a series of 5 reports by the National Centre for Monitoring Vascular Diseases at the Australian Institute of Health and Welfare that describe the combined burden of cardiovascular disease (including coronary heart disease and stroke), diabetes and chronic kidney disease. This report on prevalence and incidence provides a comprehensive summary of the latest available data on the prevalence and incidence in the Australian population of these three chronic vascular diseases, acting alone or together. It examines age and sex characteristics and variations across population groups, by geographical location, and by socioeconomic disadvantage.”

ISSN ISSN 2204-1397; ISBN 978-1-74249-662-7

Cardiovascular disease, diabetes, chronic kidney disease affect over a quarter of Australians – AIHW – 19 November 2014

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NHS England concludes review of children heart surgery at Leeds Hospitals – NHS England – 28 October 2014

Posted on October 29, 2014. Filed under: Cardiol / Cardiothor Surg, Child Health / Paediatrics, Patient Safety, Surgery | Tags: |

NHS England concludes review of children heart surgery at Leeds Hospitals – NHS England – 28 October 2014

“The review into children’s heart surgery at Leeds Teaching Hospitals Trust concluded today (28 October) with the publication of the final two reports, undertaken by an independent investigation agency Verita.

NHS England’s deputy medical director, Dr Mike Bewick, paid tribute to all those who have contributed to the process, which was begun following the voluntary, temporary suspension of surgery at Leeds Teaching Hospitals Trust in March 2013.”

… continues

Independent review into concerns about paediatric cardiac surgery (the 14 cases) at Leeds Teaching Hospitals NHS Trust – Verita – October 2014

Leeds Teaching Hospitals NHS Trust: Overarching report about paediatric cardiac surgery – Verita – October 2014

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New checklist makes the cardiac catheterisation lab a safer place for patients – The Health Foundation [UK] – June 2014

Posted on June 27, 2014. Filed under: Cardiol / Cardiothor Surg, Patient Safety |

New checklist makes the cardiac catheterisation lab a safer place for patients – The Health Foundation [UK] – June 2014

“A team at Royal Brompton and Harefield NHS Foundation Trust have developed a safety checklist for use in the cardiac catheterisation laboratory (CCL) which has improved safety and patient experience.

The checklist was derived from the WHO safe surgery checklist and introduced as part of a safe procedure process.

Using it has made procedures safer, shorter and more efficient, and has improved team communication.

Staff liked using the checklist and would like one used if they ever needed an intervention themselves. Patients also said they felt safer when the checklist was used.

The British Cardiovascular Society has since further encouraged national dialogue by publishing new guidance about the use of safety procedure checklists in the CCL.”
BCS Cardiac Catheterisation Lab Safety Checklist

 

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Burden of disease from Household Air Pollution for 2012 – WHO – 25 March 2014

Posted on March 26, 2014. Filed under: Cardiol / Cardiothor Surg, Oncology, Respiratory Medicine | Tags: , |

Burden of disease from Household Air Pollution for 2012 – WHO – 25 March 2014

“In new estimates released today, WHO reports that in 2012 around 7 million people died – one in eight of total global deaths – as a result of air pollution exposure. This finding more than doubles previous estimates and confirms that air pollution is now the world’s largest single environmental health risk. Reducing air pollution could save millions of lives.”

… continues on the site

Report

 

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Making the connection: a call to action on vascular health [Canada] – October 2013

Posted on October 25, 2013. Filed under: Cardiol / Cardiothor Surg | Tags: |

Making the connection: a call to action on vascular health [Canada] – October 2013

“Making the Connection: A call to action on vascular health, is a direct result of Vascular 2013, Canada’s first national congress for knowledge exchange and community building in vascular health. Vascular 2013 brought together canada’s leading experts and health care advocates from multiple sectors and health disciplines to focus on and expand our understanding of vascular disease prevention and management. Recognizing the urgent need for collective action on vascular health, organizational partners — canadian cardiovascular Society, canadian Diabetes association, canadian Society of endocrinology and metabolism, canadian Stroke network, heart and Stroke Foundation and hypertension canada — endorse Making the Connection: A call to action on vascular health.”

 

 

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Making the case for cardiac rehabilitation: modelling potential impact on readmissions – NHS Improvement – March 2013

Posted on April 9, 2013. Filed under: Cardiol / Cardiothor Surg, Health Economics, Rehabilitation | Tags: |

Making the case for cardiac rehabilitation: modelling potential impact on readmissions – NHS Improvement – March 2013

“This report summarises the findings of a short study, commissioned by NHS Improvement, which models the relationship between uptake of CR and unplanned cardiac readmission rates both nationally and at commissioner level.

The primary purpose of the study was to examine the Quality, Innovation, Productivity and Prevention (QIPP) potential of CR and to establish whether the benefits of CR outweigh the costs in terms of the potential impact on readmissions alone.

Over and above the well-documented, positive effects of rehabilitation on mortality, morbidity and quality of life, the results suggest that increasing the uptake of ’gold standard’ CR has the potential to reduce cardiac-related readmissions and deliver significant financial savings.”

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Making the case for cardiac rehabilitation: modelling potential impact on readmissions – NHS Improvement – March 2013

Posted on March 20, 2013. Filed under: Cardiol / Cardiothor Surg, Rehabilitation | Tags: |

Making the case for cardiac rehabilitation: modelling potential impact on readmissions – NHS Improvement – March 2013

Extract

“The primary purpose of the study was to examine the Quality, Innovation, Productivity and Prevention (QIPP) potential of CR and to establish whether the benefits of CR outweigh the costs in terms of the potential impact on readmissions alone.

Over and above the well-documented, positive effects of rehabilitation on mortality, morbidity and quality of life, the results suggest that increasing the uptake of ’gold standard’ CR has the potential to reduce cardiac-related readmissions and deliver significant financial savings.”

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Cardiovascular Disease Outcomes Strategy [UK] – 4 March 2013

Posted on March 6, 2013. Filed under: Cardiol / Cardiothor Surg |

Cardiovascular Disease Outcomes Strategy [UK] – 4 March 2013

“Improving outcomes for people with or at risk of cardiovascular disease

The Cardiovascular Disease Outcomes Strategy provides advice to local authority and NHS commissioners and providers about actions to improve cardiovascular disease outcomes. It sets out outcomes for people with or at risk of cardiovascular disease (CVD) in line with the NHS and public health outcomes frameworks.  It identifies 10 main actions to improve outcomes.”

… continues

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Treatment Strategies for Women With Coronary Artery Disease – Agency for Healthcare Research and Quality [US] – August 2012

Posted on August 30, 2012. Filed under: Cardiol / Cardiothor Surg, Comparative Effectiveness Research | Tags: |

Treatment Strategies for Women With Coronary Artery Disease – Agency for Healthcare Research and Quality [US] – August 2012

Dolor RJ, Melloni C, Chatterjee R, Allen LaPointe NM, Williams JB Jr., Coeytaux RR, McBroom AJ, Musty MD, Wing L, Samsa GP, Patel MR.
Treatment Strategies for Women With Coronary Artery Disease. Comparative Effectiveness Review No. 66.
(Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I.) AHRQ Publication No. 12-EHC070-EF Rockville, MD. Agency for Healthcare Research and Quality. August 2012

“Structured Abstract

Objectives. Although coronary artery disease (CAD) is the leading cause of death for women in the United States, treatment studies to date have primarily enrolled men and may not reflect the benefits and risks that women experience. Our systematic review of the medical literature assessed the comparative effectiveness of major treatment options for CAD specifically in women. The comparisons were (1) percutaneous coronary intervention (PCI) versus fibrinolysis/supportive pharmacologic therapy in ST elevation myocardial infarction (STEMI), (2) early invasive versus initial conservative management in non-ST elevation myocardial infarction (NSTEMI) or unstable angina, and (3) PCI versus coronary artery bypass surgery (CABG) versus optimal medical therapy in stable or unstable angina. The endpoints assessed were clinical outcomes, modifiers of effectiveness by demographic and clinical factors, and safety outcomes.”

… continues on the site

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Healthcare Cost and Utilization Project Projections: Cardiovascular/Cerebrovascular Conditions and Procedures 2011 to 2012 – 10 July 2012

Posted on July 16, 2012. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt, Health Economics, Neurology | Tags: , , |

Healthcare Cost and Utilization Project Projections: Cardiovascular/Cerebrovascular Conditions and Procedures 2011 to 2012 – 10 July 2012

U.S. Agency for Healthcare Research and Quality, HCUP
by Steiner C, Barrett M, Weiss A.

Extract from the introduction:

“40 percent of Americans. Heart disease and stroke are the first and fourth leading causes of death in the United States, and these diseases are among the most common and costly reasons for hospital admissions.2,3 The prevalence of cardiovascular and cerebrovascular diseases increases with age, with cardiovascular disease occurring in fewer than 20 percent of adults age 20-39 but more than 70 percent of adults age 60-79. Gender differences in these diseases also exist, with increasing rates by age of first major cardiovascular events for both men and women, but with a 10-year lag in the rates among women. The Affordable Care Act provides up to $100 million for community programs targeted at reducing chronic diseases, including heart disease and stroke, and another $40 million for statewide efforts focused on chronic diseases.

Timely information on trends for cardiovascular/cerebrovascular conditions and procedures provides analysts and policy makers baseline information and can be used to help evaluate the impact of health improvement efforts. A novel initiative from the Agency for Healthcare Research and Quality’s (AHRQ) Healthcare Cost and Utilization Project (HCUP) is used in this report to produce timely, current inpatient statistics on cardiovascular/cerebrovascular conditions and procedures.

The HCUP State Inpatient Databases (SID) from 2001 to 2010 include about 330 million inpatient discharges from 46 States. The list of statewide data organizations that contribute to HCUP is available in Appendix I. In this report we use the historical SID data with early 2011 data from 10 HCUP States to develop national quarterly projections of 2011 and 2012 inpatient statistics for:

  • cardiovascular/cerebrovascular system conditions, overall
  • five specific cardiovascular/cerebrovascular conditions
  • cardiovascular/cerebrovascular system procedures, overall
  • four specific cardiovascular/cerebrovascular procedures.”

… continues on the site

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Cardiac Arrest Procedures: Time to Intervene? – National Confidential Enquiry into Patient Outcome and Death (NCEPOD) 2012 report – 1 June 2012

Posted on June 5, 2012. Filed under: Cardiol / Cardiothor Surg, Patient Safety | Tags: |

Cardiac Arrest Procedures: Time to Intervene? – National Confidential Enquiry into Patient Outcome and Death (NCEPOD) 2012 report – 1 June 2012

“This NCEPOD report highlights the process of care for patients aged 16 and over, who received cardiopulmonary resuscitation in an in-hospital setting. The report takes a critical look at areas where the care of patients might have been improved, and factors which may have affected the decision to initiate a resuscitation attempt. Remediable factors have also been identified in the clinical and the organisational care of these patients.”

News release: A third of in-hospital cardiac arrests and subsequent attempts to resuscitate could have been prevented, national enquiry says

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Adults living with congenital heart disease: Improving everyday life for adults with congenital heart disease – NHS Specialised Services – 18 May 2012

Posted on May 21, 2012. Filed under: Cardiol / Cardiothor Surg |

Adults living with congenital heart disease: Improving everyday life for adults with congenital heart disease – NHS Specialised Services – 18 May 2012

News release

“A new document, Adults living with congenital heart disease, is published today to mark the start of a period of public engagement by the NHS on the future shape of services for adults with congenital heart disease (ACHD) in England. The review is led by NHS Specialised Services on behalf of specialised commissioners in England.

The review, which is in collaboration with the relevant medical, nursing and patients’ associations, has been prompted by the increasing population of adults living with congenital heart disease. Those with the condition are living longer yet specialist services have developed in an unplanned way in some areas of the country. Evidence also shows that some hospitals are carrying out just a handful of surgical procedures on ACHD patients, resulting in some clinicians not carrying out enough procedures to be sure of developing their skills and delivering the best outcomes for patients.”

… continues

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National Audit of Sudden Arrhythmic Death Syndrome Annual Report 2011 – NHS Information Centre – April 2012

Posted on April 20, 2012. Filed under: Cardiol / Cardiothor Surg | Tags: |

National Audit of Sudden Arrhythmic Death Syndrome Annual Report 2011 – NHS Information Centre – April 2012

“Risk of sudden heart death higher in males, new report suggests

Call for more hospital participation in ground-breaking audit

Men are more at risk than women of dying suddenly from cardiac arrest caused by irregular heart rhythms, a new report from the National Audit of Sudden Arrhythmic Death Syndrome (SADS) suggests.

The second report from the audit also suggests the biggest proportion of SADS happens to people in their 30s.

Managed by the Health and Social Care Information Centre in partnership with the UK Cardiac Pathology Network and commissioned by the Healthcare Quality Improvement Partnership, the audit analysed results of 317 cases from 17 hospitals recorded since July 2008.

Its findings include:”

… continues on the site

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After the event: getting care right for patients after a heart attack – Heart UK – 16 January 2012

Posted on January 17, 2012. Filed under: Cardiol / Cardiothor Surg, Rehabilitation | Tags: |

After the event: getting care right for patients after a heart attack – Heart UK – 16 January 2012

Full text of the report 

“HEART UK, the Cholesterol Charity, has today called on all NHS Trusts to offer cardiac rehabilitation services to patients more vigorously following the launch of a report highlighting the shocking inequalities in treatment after a heart attack in England.

The cardiac rehabilitation report, entitled ‘After the event: getting care right for patients after a heart attack’, found that 2,100 patients across England are not being offered cardiac rehabilitation despite the clear benefits of the service in improving patient experience and outcomes from the disease.

HEART UK Chief Executive Jules Payne said: “It is encouraging that many patients are offered cardiac rehabilitation after they have had a heart attack but the variation in uptake across the country is unacceptable. Action is needed on both a national and local level to ensure that all patients are offered this service to help them to recover and return to normal life as soon as possible after their heart attack.”

… continues on the site

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Monitoring acute coronary syndrome using national hospital data: An information paper on trends and issues – AIHW – 22 December 2011

Posted on January 4, 2012. Filed under: Cardiol / Cardiothor Surg | Tags: |

Monitoring acute coronary syndrome using national hospital data: An information paper on trends and issues – AIHW – 22 December 2011

“Acute coronary syndrome (ACS) refers to the spectrum of acute coronary artery diseases spanning acute myocardial infarction (AMI) and unstable angina (UA). They are sudden, severe and life-threatening events. This report reviews the current algorithm for monitoring the incidence of ACS in Australia, presenting a detailed analysis of hospitalisations for AMI and UA. It also presents a range of alternative algorithms for the estimation of ACS incidence. Further work is required to validate these algorithms.”

ISBN 978-1-74249-273-5; Cat. no. CVD 57; 136pp.

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Cholesterol and a healthier nation: shared responsibility for better public health – Heart UK – 2011

Posted on December 16, 2011. Filed under: Cardiol / Cardiothor Surg, Preventive Healthcare, Public Hlth & Hlth Promotion |

Cholesterol and a healthier nation: shared responsibility for better public health – Heart UK – 2011

Extract from the foreword:

“This excellent report by HEART UK, the Cholesterol Charity, is an important reminder to all involved in the NHS and policy making to keep heart disease as a number one priority. It is also a wake-up call for the new NHS Health Checks programme – a great initiative to help early diagnosis and prevention of  ardiovascular disease – despite clear instructions from both the current and the previous government, at least nine PCTs have failed to offer a single health check since roll-out of the programme began in 2009.”

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Transition of Care for Acute Stroke and Myocardial Infarction Patients: From Hospitalization to Rehabilitation, Recovery, and Secondary Prevention – AHRQ – October 2011

Posted on November 11, 2011. Filed under: Cardiol / Cardiothor Surg, Neurology, Preventive Healthcare, Rehabilitation | Tags: |

Transition of Care for Acute Stroke and Myocardial Infarction Patients: From Hospitalization to Rehabilitation, Recovery, and Secondary Prevention – AHRQ – October 2011

AHRQ = US Agency for Healthcare Research and Quality

“Structured Abstract

Objectives: To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarction (MI). This review was framed around five areas of investigation:

1.Key components of transition of care services.
2.Evidence for improvement in functional outcomes, morbidity, mortality, and quality of life.
3.Associated risks or potential harms.
4.Evidence for improvement in systems of care.
5.Evidence that benefits and harms vary by patient-based or system-based characteristics.

Data Sources: MEDLINE®, CINAHL®, Cochrane Database of Systematic Reviews, and Embase®.

Review Methods: We included studies published in English from 2000 to 2011 that specified postacute hospitalization transition of care services as well as prevention of recurrent stroke or MI.

Results: A total of 62 articles representing 44 studies were included for data abstraction. Transition of care interventions were grouped into four categories:

1.Hospital-initiated support for discharge was the initial stage in the transition of care process.
2.Patient and family education interventions were started during hospitalization but were continued at the community level.
3.Community-based models of support followed hospital discharge.
4.Chronic disease management models of care assumed the responsibility for long-term care.

Early supported discharge after stroke was associated with reduced total hospital length of stay without adverse effects on functional recovery, and specialty care after MI was associated with reduced mortality. Because of several methodological shortcomings, most studies did not consistently demonstrate that any specific intervention resulted in improved patient- or system-based outcomes. Some studies included more than one intervention, which made it difficult to determine the effect of individual components on clinical outcomes. There was inconsistency in the definition of what constituted a component of transition of care compared to “standard care.” Standard care was poorly defined, and nearly all studies were underpowered to demonstrate a statistical benefit. The endpoints varied greatly from study to study. Nearly all the studies were single-site based, and most (26 of 44) were conducted in countries with national health care systems quite different from that of the U.S., therefore limiting their generalizability.

Conclusions: Although a basis for the definition of transition of care exists, more consensus is needed on the definition of the interventions and the outcomes appropriate to those interventions. There was limited evidence that two components of hospital-initiated support for discharge (early supported discharge after stroke and specialty care followup after MI) were associated with beneficial effects. No other interventions had sufficient evidence of benefit based on the findings of this systematic review. The adoption of a standard set of definitions, a refinement in the methodology used to study transition of care, and appropriate selection of patient-centered and policy-relevant outcomes should be employed to draw valid conclusions pertaining to specific components of transition of care.”

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Safe and Sustainable: Review of Children’s Congenital Heart Services in England – Health Impact Assessment: Interim Report – August 2011

Posted on August 11, 2011. Filed under: Cardiol / Cardiothor Surg, Child Health / Paediatrics | Tags: |

Safe and Sustainable: Review of Children’s Congenital Heart Services in England – Health Impact Assessment: Interim Report – August 2011    NHS Specialised Commissioning Team

Extract from the introduction:

“In April 2010 the NHS published Safe and Sustainable: The Need for Change which set out proposals for a new model of provision for children’s heart surgery1 in England. It envisaged fewer, larger specialist surgical centres working within regional paediatric cardiology networks delivering care as close as possible to the child’s home.

Safe and Sustainable aims to develop a national service with better clinical outcomes and a trained clinical workforce which is expert in the care and treatment of children and young people with congenital heart disease. This review is being managed by National Specialised Commissioning Team (NSCT) on behalf of the ten Specialised Commissioning Groups (SCGs) in England2 and their constituent Primary Care Trusts (PCTs). Its scope includes England and Wales.3

The Safe and Sustainable Review was instigated in response to concerns among clinicians, professional organisations and parents regarding the future resilience of the existing 11 surgical centres which currently provide paediatric cardiac surgery. There have been long-standing doubts about whether some of these centres are performing a sufficient number of complex procedures to maintain and develop specialist skills.4 In 2006, a national workshop of surgical experts, together with other NHS staff and parent groups, endorsed the view that the current configuration of services in England was unsustainable.5 This view was  then echoed by an independent report by the Royal College of Surgeons in 2007.

Responding to these concerns, the Safe and Sustainable Review proposed reducing the number of centres providing children’s heart surgery from 11 to either six or seven.”  … continues

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A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases – Institute of Medicine – released 22 July 2011

Posted on July 25, 2011. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt, Health Status, Public Hlth & Hlth Promotion, Respiratory Medicine | Tags: |

A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases – Institute of Medicine – released 22 July 2011
full text

“Chronic diseases, such as cardiovascular disease and chronic lung disease, are common and costly, yet they also are among the most preventable health problems. Surveillance systems focused on chronic diseases have a potentially key role in reducing this health toll. Currently, surveillance data are collected from a variety of sources, often with beneficial results. But a critical link is missing: There is no surveillance system that operates on a national basis and in a coordinated manner to integrate current and emerging data on chronic diseases and generate timely guidance for stakeholders at the local, state, regional, and national levels. To help close this gap, two federal health agencies—the National Heart, Lung, and Blood Institute of the National Institutes of Health, and the Division for Heart Disease and Stroke Prevention of the Centers for Disease Control and Prevention—asked the IOM to develop a framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung disease.

In this report, the IOM presents a conceptual framework for national surveillance of cardiovascular and chronic lung disease and calls on the Department of Health and Human Services (HHS) to adopt it. The IOM recommends that HHS take the lead in overseeing and coordinating development and implementation efforts of a national surveillance system using this framework. In its design, HHS should work to develop a system that can provide various types of data that individually and collectively can be used to understand the continuum of disease prevention, progression, treatment, and outcomes. Without a national surveillance system, the gaps in current monitoring approaches will continue to exist, making it more difficult to track the nation’s health status despite advances in technology and data collection. The framework put forth by the IOM not only could help with tracking and monitoring cardiovascular and chronic lung disease but might well become a building block for an integrated surveillance system for the broad spectrum of chronic diseases.”

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National Cardiac Surgery Update: And the Formations of the New Zealand Cardiac Network – NZ – July 2011

Posted on July 7, 2011. Filed under: Cardiol / Cardiothor Surg |

National Cardiac Surgery Update: And the Formations of the New Zealand Cardiac Network – NZ –  July 2011

“Summary of publication

This publication looks at the work of the National Cardiac Surgery Clinical Network, and their work with the National Health Board (NHB)and District Health Boards (DHBs) throughout New Zealand to help reduce patient waiting times to levels never achieved before.

Significant progress has been made in increasing the volume of cardiac surgery operations, improving the geographic equity of cardiac surgery provision, enhancing the effectiveness of clinical prioritisation, and reducing the number of patients waiting for surgery.”

ISBN number: 978-0-478-37476-6 (Online), 978-0-478-3780-3 (print)
HP number: 5385

Citation: Ministry of Health. 2011. National Cardiac Surgery Update: and the formation of the New Zealand Cardiac Network. Wellington: Ministry of Health.

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Chronic Disease Care: A piece of the picture, July 2009 to June 2010 – NSW Bureau of Health Information – June 2011

Posted on June 24, 2011. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt, Respiratory Medicine | Tags: , |

Chronic Disease Care: A piece of the picture, July 2009 to June 2010 – NSW Bureau of Health Information – June 2011

Chronic Disease Care provides information about potentially avoidable admissions for chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) in NSW public hospitals, July 2009 to June 2010.

Bureau of Health Information. Chronic Disease Care: A piece of the picture.
2(1). Sydney (NSW); 2011.    The Insights Series

State Health Publication Number: (BHI) 110135
ISSN 1839-1680 ISBN 978-1-74187-604-8

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NICE backs use of new cardiac output monitoring device by the NHS – 29 March 2011

Posted on March 30, 2011. Filed under: Cardiol / Cardiothor Surg, Surgery | Tags: , |

NICE backs use of new cardiac output monitoring device by the NHS

“The National Institute for Health and Clinical Excellence (NICE) has today (Wednesday 30 March) published final guidance which supports the case for adoption of CardioQ-ODM in the NHS. Based on the best available evidence and expert advice, the Institute found this new device offers proven advantages for both patients and the NHS. It advises CardioQ-ODM should be considered for use in patients undergoing major or high-risk surgery, or for other surgical patients who may require invasive cardiovascular monitoring.”  …continues on the site

 CardioQ-ODM (oesophageal Doppler monitor)

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Maintaining patients’ trust: modern medical professionalism – Society for Cardiothoracic Surgeons in Great Britain and Ireland (SCTS) – 21 March 2011

Posted on March 24, 2011. Filed under: Cardiol / Cardiothor Surg, Patient Safety, Surgery |

Maintaining patients’ trust: modern medical professionalism – Society for Cardiothoracic Surgeons in Great Britain and Ireland (SCTS) – 21 March 2011
 
“The Society for Cardiothoracic Surgeons in Great Britain and Ireland (SCTS) has been collecting outcomes following surgery since 1977. In 2001 the adult cardiac surgery database was introduced and in 2005 SCTS published clinical outcomes through the Care Quality Commission website.
 
SCTS is launching its report ‘Maintaining patients’ trust: modern medical professionalism’ on Monday 21st March. This report includes submissions from a range of respected external organisations and opinion leaders. It describes SCTS’ work on:” … continues on the SCTS site

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Cardiovascular disease: Australian facts 2011 – AIHW – 17 March 2011

Posted on March 24, 2011. Filed under: Cardiol / Cardiothor Surg | Tags: |

Cardiovascular disease: Australian facts 2011 – AIHW – 17 March 2011

Australian Institute of Health and Welfare

“Cardiovascular disease (CVD) is a very common and serious disease in Australia with about 3.5 million people reporting having the condition in 2007-08. Despite significant advances in the treatment of CVD and for some of its risk factors, it remains the cause of more deaths than any other disease – about 50,000 in 2008 – and the most expensive, costing about $5.9 billion in 2004-05. And not all sectors of Australian society are affected equally by CVD with people in lower socioeconomic groups, Aboriginal and Torres Strait Islander people and those living in the remote areas of Australia often more likely to be hospitalised with, or to die from CVD than other members of the population.”

ISSN 1323-9236; ISBN 978-1-74249-130-1

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Project Retrosight: Understanding the returns from cardiovascular and stroke research: The Policy Report – RAND – March 2011

Posted on March 18, 2011. Filed under: Cardiol / Cardiothor Surg, Neurology, Research | Tags: |

Project Retrosight: Understanding the returns from cardiovascular and stroke research: The Policy Report – RAND – March 2011
by Steven Wooding, Stephen Hanney, Alexandra Pollitt, Martin Buxton, Jonathan Grant

“This project explores the impacts arising from cardiovascular and stroke research funded 15-20 years ago and attempts to draw out aspects of the research, researcher or environment that are associated with high or low impact.

The project is a case study-based review of 29 cardiovascular and stroke research grants, funded in Australia, Canada and UK between 1989 and 1993. The case studies focused on the individual grants but considered the development of the investigators and ideas involved in the research projects from initiation to the present day. Grants were selected through a stratified random selection approach that aimed to include both high- and low-impact grants. The key messages are as follows: 1) The cases reveal that a large and diverse range of impacts arose from the 29 grants studied. 2) There are variations between the impacts derived from basic biomedical and clinical research. 3) There is no correlation between knowledge production and wider impacts 4) The majority of economic impacts identified come from a minority of projects. 5) We identified factors that appear to be associated with high and low impact.

This report presents the key observations of the study and an overview of the methods involved. It has been written for funders of biomedical and health research and health services, health researchers, and policy makers in those fields. It will also be of interest to those involved in research and impact evaluation.” 

Research Brief on Project Retrosight

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New blood pressure measurement device to revolutionise the way blood pressure is measured – 21 February 2011

Posted on February 24, 2011. Filed under: Cardiol / Cardiothor Surg, Health Technology Assessment |

New blood pressure measurement device to revolutionise the way  blood pressure is measured – 21 February 2011

“A new blood pressure measurement device, invented by scientists at the University of Leicester and in Singapore is set to revolutionise the way patients’ blood pressure is measured.

The CASPal blood pressure measurement device gives a more accurate reading than the current method used. It does this by measuring the pressure close to the heart – the central aortic systolic pressure or CASP.

Blood pressure, currently measured in the arm may not always accurately reflect what the pressure is in the larger arteries close to the heart.”  …continued on the site

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Selecting Patients for ICD Implantation: Are Clinicians Choosing Appropriately? – JAMA January 2011

Posted on January 25, 2011. Filed under: Cardiol / Cardiothor Surg, Evidence Based Practice |

Non–Evidence-Based ICD Implantations in the United States
Sana M. Al-Khatib,  et al    JAMA 2011:305(1):43-49
Abstract

Context Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symptoms or a recent diagnosis of heart failure.

Objective To determine the number, characteristics, and in-hospital outcomes of patients who receive a non–evidence-based ICD and examine the distribution of these implants by site, physician specialty, and year of procedure.

Design, Setting, and Patients Retrospective cohort study of cases submitted to the National Cardiovascular Data Registry-ICD Registry between January 1, 2006, and June 30, 2009.

Main Outcome Measure In-hospital outcomes.

Results Of 111 707 patients, 25 145 received non–evidence-based ICD implants (22.5%). Patients who received a non–evidence-based ICD compared with those who received an evidence-based ICD had a significantly higher risk of in-hospital death (0.57% [95% confidence interval {CI}, 0.48%-0.66%] vs 0.18% [95% CI, 0.15%-0.20%]; P <.001) and any postprocedure complication (3.23% [95% CI, 3.01%-3.45%] vs 2.41% [95% CI, 2.31%-2.51%]; P <.001). There was substantial variation in non–evidence-based ICDs by site. The rate of non–evidence-based ICD implants was significantly lower for electrophysiologists (20.8%; 95% CI, 20.5%-21.1%) than nonelectrophysiologists (24.8% [95% CI, 24.2%-25.3%] for nonelectrophysiologist cardiologists; 36.1% [95% CI, 34.3%-38.0%] for thoracic surgeons; and 24.9% [95% CI, 23.8%-25.9%] for other specialties) (P<.001 for all comparisons). There was no clear decrease in the rate of non–evidence-based ICDs over time (24.5% [6908/28 233] in 2006, 21.8% [7395/33 965] in 2007, 22.0% [7245/32 960] in 2008, and 21.7% [3597/16 549] in 2009; P <.001 for trend from 2006-2009 and P = .94 for trend from 2007-2009).

Conclusion Among patients with ICD implants in this registry, 22.5% did not meet evidence-based criteria for implantation.
Selecting Patients for ICD Implantation: Are Clinicians Choosing Appropriately?
Alan Kadish, Jeffrey Goldberger
JAMA. 2011;305(1):91-92.

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Multi-City Mortality & Morbidity Study – Environmental Protection and Heritage Council – reports dated 9 September 2010

Posted on September 14, 2010. Filed under: Cardiol / Cardiothor Surg, Environmental Health, Respiratory Medicine | Tags: , , |

Multi-City Mortality & Morbidity Study – Environmental Protection and Heritage Council – reports dated 9 September 2010

“In May 2003, the Environment Protection and Heritage Council approved a research study which examined the effects of air pollution of human health in Sydney, Melbourne, Brisbane, Perth, and Canberra in Australia, and from Auckland and Christchurch in New Zealand.

The study included an analysis of data from these cities on mortality and hospital admissions for respiratory and cardiovascular disease using a standardised statistical approach consistent with large multi-city studies in the USA and Europe. The study also included an analysis of the health effects attributed to PM2.5 and PM10. The principal investigators were the University of the Sunshine Coast in association with the School of Population Health, University of Queensland, and associate investigators include New South Wales Health, Queensland Health, Environment Protection Victoria, West Australian Department of Environment Protection, Environment ACT, and the New Zealand Ministry for the Environment.

A final report of the study was presented by the investigators in 2006. A peer review of the study was initiated in 2007, focusing on the study design, the soundness and reliability of the statistical methods used and whether the methods employed had been applied appropriately.

The peer review was conducted by international experts (Prof Ross Anderson and Dr Richard Atkinson, St Georges Hospital, London; Dr Lucas Neas, US EPA; and, Dr Annette Peters, GSF Germany). All reviewers provided positive responses to the report and did not identify any issues with the method used in the analysis. Most comments focused on interpretation and presentation of the results. These issues were relayed to the researchers and were addressed in the finalisation of the report for the EPHC in July 2010.

The study will provide useful information for the review of the Ambient Air Quality NEPM.”

Expansion of the Multi-City Mortality and Morbidity Study – Executive Summary & Summary Report – Sept 2010 222KB

Multi-city – Volume 1 – Expansion of the Multi-City Mortality and Morbidity Study – Sept 2010 183KB

Multi-city – Volume 2 – Expansion of the Multi-City Mortality and Morbidity Study – Sept 2010 1.69MB

Multi-city – Volume 3 – Expansion of the Multi-City Mortality and Morbidity Study – Sept 2010 1.81MB

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Vulnerable Atherosclerotic Plaque – Technical Brief from the AHRQ Effective Health Care Program – 16 August 2010

Posted on August 27, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Vulnerable Atherosclerotic Plaque – Technical Brief from the AHRQ Effective Health Care Program – 16 August 2010

AHRQ = Agency for Healthcare Research and Quality
AHRQ Publication No. 10-EHC-062-EF 

Medical researchers seeking more precise ways to predict a patient’s susceptibility to heart attacks and strokes are not close to finding a clinically and biologically superior method of doing so, according to a new AHRQ-funded study.  The report examines scientific literature of vulnerable plaques, a concept that proposes that biologically unstable areas of arteries could rupture and form a local blood clot that blocks the flow of blood through the artery to the heart or brain, causing a heart attack or stroke.  However, the report’s authors found substantial challenges in identifying unique characteristics of vulnerable plaques that can reliably be used in clinical practice to identify patients who are at higher risk of developing a heart attack or stroke.  The report was produced by AHRQ’s Tufts Medical Center Evidence-based Practice Center and was published online in Annals of Internal Medicine.  Select to access the full report.

Alsheikh-Ali A, Kitsios GD, Balk E, Mahoney A, Lau J, Ip S. Vulnerable Atherosclerotic Plaque. Technical Brief No. 4 (Prepared by Tufts Evidence-based Practice Center under Contract No. HHSA-290-02-0022-EPC II.) AHRQ Publication No. 10-EHC062-EF. Rockville, MD: Agency for Healthcare Research and Quality. August 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm

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Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and Harms – Clinician Guide – 9 July 2010

Posted on August 16, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Adding ACEIs and/or ARBs to Standard Therapy for Stable Ischemic Heart Disease: Benefits and HarmsClinician Guide – 9 July 2010

AHRQ = US Agency for Healthcare Research and Quality

Key Clinical Issue
Should standard medical therapy in patients with stable ischemic heart disease be augmented with an ACEI angiotensin-converting enzyme inhibitor) or an ARB (angiotensin II receptor blocker)?

Consumer Guide – 9 July 2010

“ACE Inhibitors” and “ARBs” To Protect Your Heart?

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Technical Brief: Percutaneous Heart Valve Replacement – AHRQ – 2 August 2010

Posted on August 11, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

Technical Brief: Percutaneous Heart Valve Replacement – AHRQ – 2 August 2010

Risks, Benefits of Emerging Heart Valve Replacement Technique Not Fully Understood – AHRQ – 2 August 2010

AHRQ = US Agency for Healthcare Research and Quality

Full text of the Technical Brief on Percutaneous Heart Valve Replacement

“A newer, less invasive method of heart valve replacement shows promise and may be appropriate for patients who cannot tolerate traditional open heart surgery, but research is needed to understand its potential risks and benefits, according to a new study funded by the Department of Health & Human Services’ (HHS) Agency for Healthcare Research and Quality (AHRQ).

The report finds that percutaneous heart valve replacement, a procedure in which a replacement valve is implanted through a catheter rather than by open heart surgery, is a realistic option for some patients with heart valve disease, especially older or sicker patients. The report found that percutaneous heart valve replacement may be a safe and effective alternative to open heart surgery, especially in the short term, for those patients. However, information is lacking on the potential long-term benefits and risks of this procedure, particularly compared with open heart valve replacement surgery. The report did not conclude that any of the seven valves studied is safer or more effective than another.

The report was produced by the Duke Evidence-based Practice Center for AHRQ, a leading Federal agency conducting comparative effectiveness research. Results of the report were published online today in Annals of Internal Medicine. Heart valve disease—a narrowing of the heart valve—is blamed for approximately 20,000 deaths a year.”

…continues on the site

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NICE publishes final draft guidance on the use of dronedarone for treating atrial fibrillation – 16 July 2010

Posted on July 27, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: , |

NICE publishes final draft guidance on the use of dronedarone for treating atrial fibrillation – 16 July 2010

“The National Institute for Health and Clinical Excellence (NICE) is currently appraising the use of dronedarone (Multaq) for the treatment of atrial fibrillation (AF) – a disturbance of the heart’s rhythm. In its final draft guidance published today, (16 July), NICE has reaffirmed the decision in its previous draft to recommend the limited use of the drug as a second-line treatment in people with additional cardiovascular risk factors whose AF has not been controlled by first-line therapy.

Sir Andrew Dillon, NICE Chief Executive, said: “The independent Appraisal Committee concluded that although dronedarone reduced atrial fibrillation recurrence compared with placebo, it appeared to be less effective for atrial fibrillation recurrence than other antiarrhythmic drugs. However, it noted comments from patients and clinical experts received during consultation on a previous draft that all current antiarrhythmic drugs have side effects that have a significant impact on quality of life with long-term use. It heard from patient experts that some people with atrial fibrillation might prefer to take dronedarone because it has fewer side effects, despite it being less effective in preventing recurrence of atrial fibrillation.

He continued: “The Committee also accepted evidence that the risk of mortality with dronedarone was likely to be lower than with current anti-arrhythmic drugs. Finally, because the cost-effectiveness estimates for the drug were largely based on a single clinical trial, which included people who had a higher risk of a major cardiovascular event, we have recommended that dronedarone is considered as a treatment option only in people who have additional cardiovascular risk factors such as diabetes or high blood pressure.”

In line with the NICE technology appraisals process this draft guidance is now with consultees, who have the opportunity to appeal against the proposed guidance. NICE has not yet issued final guidance to the NHS. Final guidance is expected to be published in August 2010.  …continues

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NICE – SeQuent Please balloon catheter for in-stent coronary restenosis: medical technologies consultation – July 2010

Posted on July 27, 2010. Filed under: Cardiol / Cardiothor Surg, Health Technology Assessment | Tags: |

NICE’s medical technologies programme issues first draft guidance

“The first piece of guidance has been published from NICE’s new medical technologies programme, set up to help the NHS adopt efficient and cost effective medical devices and diagnostics more rapidly and consistently.

The draft guidance recommends the use of a balloon catheter, SeQuent Please, for patients who have suffered restenosis, a condition where the blood vessels become blocked again following a previous treatment with a stent.

The Evaluation Pathway Programme for Medical Technologies was established in November 2009 to focus specifically on the evaluation of innovative medical technologies. Its purpose is to produce guidance on the use of devices and diagnostics to speed up the introduction into the health service of those products offering significant benefits, or helping technologies to be investigated more thoroughly in research.

The types of products that are assessed under the new programme are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions.

An independent group of experts, the Medical Technologies Advisory Committee (MTAC), is responsible for deciding which medical technologies should be selected for evaluation, as well as developing the guidance itself.”  … continues

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Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack – June 2010

Posted on June 4, 2010. Filed under: Aboriginal TI Health, Cardiol / Cardiothor Surg | Tags: , |

Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack

ISBN: 978-1-921226-72-4

“The Heart Foundation and Australian Healthcare and Hospitals Association report “Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack” is now available.

This report addresses the disparities in hospital care for Aboriginal and Torres Strait Islander people with acute coronary syndromes (ACS) and makes practical recommendations to close the gap in Aboriginal and Torres Strait Islander heart health.

The report was developed in response to the 2006 Australian Institute of Health and Welfare findings that, compared with other Australians, Aboriginal and Torres Strait Islander people had:

three times the rate of major coronary events, such as heart attack
1.4 times the out-of-hospital death rate from coronary heart disease (CHD)
more than twice the in-hospital death rate from CHD
a 40% lower rate of being investigated by angiography
a 40% lower rate of coronary angioplasty or stent procedures
a 20% lower rate of coronary bypass surgery.

“Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack” aims to raise awareness of these issues among governments, hospitals, clinicians and other interested parties.”

Better hospital care for Aboriginal and Torres Strait Islander people experiencing heart attack  Download

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Generation Risk – an analysis of cardiovascular disease risk among Australia’s older population – Access Economics – May 2010

Posted on May 19, 2010. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt | Tags: |

‘Generation Risk’ – an analysis of cardiovascular disease risk among Australia’s older population – Access Economics – May 2010

“This report, commissioned by Boehringer Ingelheim, involved the input of numerous medical specialists and patient advocates. The study estimates the five year cardiovascular disease (CVD) risk spectrum of Australians aged 55 years and over. It includes a review of the significant burden CVD imposes each year, the prevalence of eight known CVD risk factors, an estimation of absolute five year CVD risk prevalence in 2010 and the impact population growth and ageing will have on absolute CVD risk prevalence in the next 20 years.”

Client/Publisher: Boehringer Ingelheim
Area: Economic Consulting
Date: May 2010 

Download Generation Risk – an analysis of cardiovascular diesease risk among Australia’s older population.pdf    1437KB

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The effectiveness and cost effectiveness of biomarkers for the prioritisation of patients awaiting coronary revascularisation: a systematic review and decision model – Health Technology Assessment February 2010

Posted on April 6, 2010. Filed under: Cardiol / Cardiothor Surg, Health Technology Assessment |

The effectiveness and cost effectiveness of biomarkers for the prioritisation of patients awaiting coronary revascularisation: a systematic review and decision model – Health Technology Assessment 2010 (February); Vol. 14: No. 9

Health Technology Assessment
NIHR HTA programme

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The Canadian Heart Health Strategy: Risk Factors and Future Cost Implications – February 2010

Posted on February 15, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

The Canadian Heart Health Strategy: Risk Factors and Future Cost Implications

“The CBoC [conference Board of Canada] was contracted to investigate the potential impact on national health expenditures if risk factors related to cardiovascular diseases were reduced. This report presents the approach, methodology, and final results of the work.

Report by Sabrina Browarski , Carole Stonebridge , Louis Theriault
The Conference Board of Canada, 36 pages, February 2010

Document Highlights:

The Canadian Heart Health Strategy and Action Plan (CHHS-AP), Building a Heart Healthy Canada, seeks to reduce the growing disease and cost burdens of cardiovascular diseases (CVDs) in Canada. The CHHS-AP contracted the Conference Board to investigate the potential impact on future national health expenditures if a reduction in risk factors was achieved. This report presents the approach, methodology, and final results of the work.

The forecast looked at five risk factors: lack of physical activity, smoking, obesity, hypertension, and consumption of fruit and vegetables. The analysis was anchored in a detailed population forecast for Canada and compared two forecast scenarios.

The analysis found that achieving the CHHS-AP risk factor targets will lead to a substantial reduction in CVD-related illnesses and cost savings for the health system, governments, and Canadian economy—it suggests a cumulative cost savings of about $5 billion per year, with significantly larger savings if the forecast is extended beyond 2020.”

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NICE publishes draft recommendations on the management of chronic heart failure in adults – 14 January 2010

Posted on January 15, 2010. Filed under: Cardiol / Cardiothor Surg | Tags: |

 

NICE publishes draft recommendations on the management of chronic heart failure in adults

“NICE is in the process of updating its clinical guideline on the management of chronic heart failure in adults and has today (14 January) published its draft recommendations for public consultation.Since the original guideline was published in 2003, new high-quality evidence from randomised controlled trials in diagnosis, treatment and monitoring have been published. This partial update will ensure that the recommendations take into account the new evidence available.

Heart failure is a complex clinical syndrome of symptoms and signs such as breathlessness, fatigue and fluid retention  that suggest the efficiency of the heart is impaired. The most common cause of heart failure in the UK is coronary artery disease, with many patients having suffered a myocardial infarction (heart attack) in the past. The draft recommendations cover the diagnosis and treatment of heart failure, including defining the combination of symptoms, signs and investigations which together are most effective in confirming a diagnosis of heart failure and influencing subsequent optimum treatments.

Dr Fergus Macbeth, Director, Centre for Clinical Practice at NICE said: “The prevalence of heart failure is expected to rise in the future as more people live longer generally, people survive longer with coronary artery disease and there are better treatments for heart failure. Currently some 900,000 people in the UK have had a diagnosis of heart failure, with almost as many again who may have damaged hearts but as yet no symptoms. It’s clearly very important that clinicians working in this area have a guideline that is based on the most up-to-date evidence of what works best. This new draft guideline outlines a comprehensive approach to the management of heart failure, and  ultimately seeks to improve the length and quality of life of people with the condition.

Dr Macbeth continued:“The draft guideline clearly indicates those recommendations that are new or have been changed from the original. For example, the original guideline recommended the use of echocardiography to help confirm a diagnosis of heart failure only after other tests were inconclusive. However, based on a review of new evidence about the best way for primary care physicians to diagnose heart failure published since the original NICE guideline, the updated draft recommends that people with suspected heart failure and who have had a previous heart attack should be referred urgently for echocardiography and specialist assessment.”

The draft recommendations are available on the NICE website.  ”

NICE publishes draft recommendations on the management of chronic heart failure in adults
14 January 2010  (36.14 Kb 10 sec @ 28.8Kbps)

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Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors – AIHW – 11 December 2009

Posted on December 11, 2009. Filed under: Cardiol / Cardiothor Surg, Chronic Disease Mgmt, Diabetes, Nephrology, Public Hlth & Hlth Promotion | Tags: , |

Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors

Authored by AIHW – Australian Institute of Health and Welfare

“Cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD) account for around a quarter of the burden of disease in Australia, and just under two-thirds of all deaths. These three diseases often occur together and share risk factors, such as physical inactivity, overweight and obesity, and high blood pressure. This report includes information on the national prevalence of the main risk factors for CVD, CKD and diabetes as well as population initiatives and individual services that aim to prevent or control these risk factors. It shows the prevalence of some risk factors is increasing-notably obesity, which rose from 11% of adults in 1995 to 24% in 2007-08. This is the first report to present a systematic approach to monitor prevention in Australia, providing a baseline for future monitoring.”

Published 11 December 2009; ISBN-13 978 1 74024 984 3; AIHW cat. no. PHE 118; 140pp. 

Australian Government Reaction – Funding Supports Local Communities to Take Action on Obesity  –  11 December 2009

“Local government areas will receive a funding boost from the Rudd Government to foster healthier lifestyles in their communities, as the release of a sobering report shows risk factors of chronic disease continue to rise.

The Australian Institute of Health and Welfare report, Prevention of cardiovascular disease, diabetes and chronic kidney disease: targeting risk factors, says the prevalence of some risk factors – such as obesity is increasing.” … continues on the website

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The Sixth National Adult Cardiac Surgical Database – “Demonstrating Quality”

Posted on July 30, 2009. Filed under: Cardiol / Cardiothor Surg, Clin Governance / Risk Mgmt / Quality | Tags: |

The Sixth National Adult Cardiac Surgical Database – “Demonstrating Quality”
Compiled by:             Professor Sir Bruce Keogh, Mr Ben Bridgewater, Dr Robin Kinsman & Dr Peter Walton
512 page – A4 Hardback            ISBN 1-903968-23-2    Price: £100.00 (plus p&p)

“The sixth edition in the series of ‘National Adult Cardiac Surgical Database Reports’ from the Society for Cardiothoracic Surgery in Great Britain & Ireland, is the most comprehensive documentation of current cardiac practice ever published. This latest Report analyses over 400,000 patient records collected over a 15–year period (1994–2008), subjecting the specialty of cardiac surgery to an unrivalled degree of scrutiny. This latest edition expands upon the previous reports and as well as including coronary artery bypass surgery, the 2009 Report features detailed and comprehensive information regarding aortic valve surgery, mitral valve surgery, major aortic surgery and multiple valve and the other miscellaneous cardiac operations. The Report contains analyses that show:

* Significant improvements in survival for most cardiac surgical procedures, despite increasing complexity of case mix and an increasing proportion of elderly patients undergoing heart surgery.
* Variations in the types of surgery undertaken for various disorders between hospitals, marked differences in volumes and significant variations in equity of access to potentially life-saving treatments by geographical region.

In addition to these detailed procedure-specific analyses, the report examines the methodological issues around predicting operative risk and adjusting for case mix, which are both essential if comparisons are to be made about differing outcomes between hospitals or surgeons. Furthermore, the mortality outcomes are also featured for all hospitals, which performed surgery for all cardiac surgery, isolated coronary artery bypass surgery and isolated aortic valve surgery, using appropriate risk-adjustment methodology.

The Report clearly justifies the decision to openly scrutinise and publish cardiac surgical results in the United Kingdom and will rightly be hailed as an example to other specialties around the world wishing to undertake clinical audit.”

An article about this clinical audit process:

Ben Bridgewater on why funding clinical audit is essential
30 July 2009 | By Ben Bridgewater

“Observing clinical outcomes and ensuring they enrich the NHS’s wealth of data is essential so audit must be fully backed by national funding, leadership and IT

“Observation affects reality” – the theory that the act of studying a process alters the outcome is well proven. In a healthcare system where the primary strategies for driving improvement have been target setting and researching new treatments, does this mean an opportunity has been missed? Can healthcare be improved simply by clinicians properly observing current practice?

Cardiac surgeons set about collecting simple data in 1977 but in recent years they have developed a professionally led audit database that benchmarks mortality outcomes. All units report and the database now includes outcomes on over 400,000 operations.

The sixth Society of Cardiothoracic Surgery national database report published this week, the first for five years, is a comprehensive analysis of this data, and includes examination of trends, risks and outcomes of patients undergoing adult cardiac surgery.

The results suggest that the very process of collecting, analysing and feeding back data to units has markedly driven improvements.”   … continues on the website

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Independent validation of QRISK (cardiovascular disease risk prediction algorithm) on the THIN database – 24 July 2009

Posted on July 27, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: , |

Independent validation of QRISK on the THIN database

Document type:      Report
Author:      Dr Gary S. Collins and Professor Douglas G. Altman, Centre for Statistics in Medicine, University of Oxford
Published date:      24 July 2009

“QRISK is a new cardiovascular disease risk prediction algorithm published in 2007. This document is looking at an independent validation of the QRISK algorithm on the The Health Iimprovement Network (THIN) database. THIN has created a medical research database of anonymised patient records from information entered by general practices.”

full text of the report

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Guide to good practice in clinical perfusion – UK – 22 July 2009

Posted on July 23, 2009. Filed under: Anaesthesiology, Cardiol / Cardiothor Surg |

Guide to good practice in clinical perfusion

Document type:      Guidance
Author:   UK  Department of Health
Published date:      22 July 2009
Pages:      52

“In order to assure safe and high quality clinical perfusion services, a new guide to good practice in clinical perfusion has been developed in response to a critical incident in 2005 which led to the publication of the Gritten report. The Guide to Good Practice in Clinical Perfusion provides a Quality Management System and a Framework for the Administration of Named Medicines to form the basis of patient-specific directions which are recorded in the patient’s notes and clinical perfusion record. This guidance and the recommended frameworks should assist in the assurance of safe and high quality clinical perfusion services provided by the NHS.”

Download Guide to good practice in clinical perfusion (PDF, 873K)

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Venous thromboembolism prevention: a patient safety priority – UK – 25 June 2009

Posted on June 26, 2009. Filed under: Cardiol / Cardiothor Surg, Patient Safety | Tags: |

Venous thromboembolism prevention: a patient safety priority

Document type:      Reference
Author:     Edited by Dr Roopen Arya BMBCh MA PhD FRCP FRCPath, Director, King’s Thrombosis Centre
Published date:      25 June 2009
Pages:      42

“Resource document issued at the Leadership Summit: Venous Thromboembolism in the NHS, convened by the Chief Medical Officer and the All-Party Parliamentary Thrombosis Group”

DoH Publications

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Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism. Evidence Report/Technology Assessment – AHRQ – June 2009

Posted on June 25, 2009. Filed under: Cardiol / Cardiothor Surg, Genomics | Tags: , |

AHRQ = US Agency for Healthcare Research & Quality

Segal JB, Brotman DJ, Emadi A, Necochea AJ, Samal L, Wilson LM, Crim MT, Bass EB.
Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism. Evidence Report/Technology Assessment No. 180. (Prepared by Johns Hopkins University Evidence-based Practice Center under contract no. HHSA 290-2007-10061-I). AHRQ Publication No. 09-E011. Rockville, MD. Agency for Healthcare Research and Quality.Value of Genetic Testing for Preventing Blood Clots Unproven

AHRQ released a new evidence report that found insufficient evidence to conclude that genetic testing for two gene mutations in adults with a history of blood clots helps to prevent a condition known as deep-vein thrombosis or to improve other clinical outcomes.  The report, a summary of which will be published in the June 17 issue of JAMA, also failed to find any benefit from genetic testing of family members of patients who have at least one of the two mutations — known as Factor V Leiden (FVL) and prothrombin G20210A — as well as a history of deep-vein thrombosis.   The evidence report was requested and supported by CDC’s Office of Public Health Genomics (OPHG).  The Evaluation of Geno mic Applications in Practice and Prevention Working Group, established by OPHG in 2005, will use this evidence report and other evidence to make recommendations on the validity and utility of genetic tests for FVL and prothrombin G20210A. This report, titled Outcomes of Genetic Testing in Adults with a History of Venous Thromboembolism, was conducted by AHRQ’s Johns Hopkins Evidence-based Practice Center in Baltimore.

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The economic costs of heart attack and chest pain (Acute Coronary Syndrome) – Access Economics report – June 2009

Posted on June 24, 2009. Filed under: Cardiol / Cardiothor Surg, Health Economics | Tags: |

The economic costs of heart attack and chest pain (Acute Coronary Syndrome)

Access Economics was commissioned by Eli Lilly to estimate the economic costs of Heart Attack and Chest Pain (Acute Coronary Syndrome-ACS) in Australia for 2009.

Client/Publisher:     Eli Lilly
Area:     Economic Consulting
Date:     June 2009

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Healthcare delivery models for prevention of cardiovascular disease (CVD)

Posted on April 29, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: |

Healthcare delivery models for prevention of cardiovascular disease (CVD)

International evidence for health service providers and commissioners about how services might best prevent CVD is presented in a report from the Health Foundation. The report focuses on healthcare delivery processes that address the prevention and primary care management of modifiable CVD risk factors. There is strong evidence to show the successful impact GP-led services can have on identifying high risk patients and providing behavioural and educational services that would mitigate risk.

Published by:
The Health Foundation, London WC2E 9RA
First published 2009
ISBN 978-1-906461-07-2

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(UK) The coronary heart disease national service framework: building on excellence, maintaining progress: progress report for 2008

Posted on April 17, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: |

(UK) The coronary heart disease national service framework: building on excellence, maintaining progress: progress report for 2008

This report details the progress which has been made in implementing the Coronary Heart Disease National Service Framework in the eight years since its publication.

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Canadian Heart Health Strategy and Action Plan – February 2009

Posted on April 16, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: , |

The Canadian Heart Health Strategy and Action Plan has been released, and is described as “a road map for improving the heart health of Canadians from prevention to patient care.” The cost of the plan, which is yet to be funded, is estimated at $100 million a year over seven years, but it is also calculated that it can save the economy $7.6 billion in direct costs and $14.6 billion in indirect costs by 2020. The document can be found at http://www.chhs-scsc.ca.

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Health care expenditure on cardiovascular diseases 2004-05 Published 5 Dec 2008

Posted on March 25, 2009. Filed under: Cardiol / Cardiothor Surg | Tags: |

Health care expenditure on cardiovascular diseases 2004-05
Cardiovascular disease series no. 30

Health care expenditure on cardiovascular diseases 2004-05 presents summary data of allocated health expenditure collected by the Australian Institute of Health and Welfare. This report presents comparisons of allocated expenditure on cardiovascular disease over time and relative to other disease types. In addition, breakdowns of allocated expenditure according to age, sex and health sector are presented. This report is a useful resource for policy-makers, researchers and health professionals interested in cardiovascular disease.

Authored by Senes S & Woodall J.

Published 5 December 2008; ISSN 1323-9236; ISBN-13 978 1 74024 857 0; AIHW cat. no. CVD 43; 52pp.

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