TY - JOUR
T1 - Performance Measures Have a Major Effect on Cardiovascular Outcomes
T2 - A Review
AU - Mehta, Rajendra H.
AU - Peterson, Eric D.
AU - Califf, Robert M.
N1 - Funding Information:
Source of funding: Duke Clinical Research Institute, Durham, North Carolina. Supported in part by the Centers for Education and Research on Therapeutics Grant HS010548 from the Agency for Healthcare Research and Quality, Rockville, Maryland.
PY - 2007/5
Y1 - 2007/5
N2 - Improved application of existing therapies, directed by evidence-based guidelines, may offer immediate savings of life and function to patients with cardiovascular disease. We sought to evaluate the evidence that use of performance measures derived from clinical practice guidelines is associated with better clinical outcomes in this context. We conducted a search of the MEDLINE database for published studies evaluating the relationship of evidence-based therapies and outcomes in patients with coronary artery disease or heart failure. Studies examined included single-center, regional, national, and international experiences, and varied considerably in design. Most studies linking guidelines-based care to outcomes focused on patients with coronary artery disease; relatively few addressed patients with heart failure. Few studies, all nonrandomized, examined the use of specific interventions to improve quality of care in the context of standardized care tools. Almost all studies showed a strong and "dose-response" association between adherence to guidelines and performance measures and outcomes. Higher quality of care, as documented by better performance based on measures derived from practice guidelines, is associated with improved outcomes in patients with cardiovascular disease.
AB - Improved application of existing therapies, directed by evidence-based guidelines, may offer immediate savings of life and function to patients with cardiovascular disease. We sought to evaluate the evidence that use of performance measures derived from clinical practice guidelines is associated with better clinical outcomes in this context. We conducted a search of the MEDLINE database for published studies evaluating the relationship of evidence-based therapies and outcomes in patients with coronary artery disease or heart failure. Studies examined included single-center, regional, national, and international experiences, and varied considerably in design. Most studies linking guidelines-based care to outcomes focused on patients with coronary artery disease; relatively few addressed patients with heart failure. Few studies, all nonrandomized, examined the use of specific interventions to improve quality of care in the context of standardized care tools. Almost all studies showed a strong and "dose-response" association between adherence to guidelines and performance measures and outcomes. Higher quality of care, as documented by better performance based on measures derived from practice guidelines, is associated with improved outcomes in patients with cardiovascular disease.
KW - Cardiovascular disease
KW - Guidelines
KW - Performance measures
UR - http://www.scopus.com/inward/record.url?scp=34247201574&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34247201574&partnerID=8YFLogxK
U2 - 10.1016/j.amjmed.2006.12.018
DO - 10.1016/j.amjmed.2006.12.018
M3 - Review article
C2 - 17466646
AN - SCOPUS:34247201574
SN - 0002-9343
VL - 120
SP - 398-402.e6
JO - American Journal of Medicine
JF - American Journal of Medicine
IS - 5
ER -