门诊护理研究团队中的心血管健康（CANHEART）：利用大数据来衡量和改善心血管健康及医疗服务。
The Cardiovascular Health in Ambulatory Care Research Team (CANHEART): using big data to measure and improve cardiovascular health and healthcare services.
作者信息
Tu Jack V, Chu Anna, Donovan Linda R, Ko Dennis T, Booth Gillian L, Tu Karen, Maclagan Laura C, Guo Helen, Austin Peter C, Hogg William, Kapral Moira K, Wijeysundera Harindra C, Atzema Clare L, Gershon Andrea S, Alter David A, Lee Douglas S, Jackevicius Cynthia A, Bhatia R Sacha, Udell Jacob A, Rezai Mohammad R, Stukel Thérèse A
机构信息
From the Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada (J.V.T., A.C., L.R.D., D.T.K., G.L.B., K.T., L.C.M., H.G., P.C.A., W.H., M.K.K., H.C.W., C.L.A., A.S.G., D.A.A., D.S.L., C.A.J., R.S.B., J.A.U., M.R.R., T.A.S.); Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (J.V.T., D.T.K., H.C.W.); University of Toronto, Toronto, Ontario, Canada (J.V.T., A.C., D.T.K., G.L.B., K.T., P.C.A., M.K.K., H.C.W., C.L.A., A.S.G., D.A.A., D.S.L., C.A.J., R.S.B., J.A.U., T.A.S.); Division of Endocrinology, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada (G.L.B.); Toronto Western Hospital Family Health Team, University Health Network, Toronto, Ontario, Canada (K.T.); Ottawa Research Group for Primary Health Care, Ottawa, Ontario, Canada (W.H.); Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada (W.H.); Division of General Internal Medicine and Clinical Epidemiology, University Health Network, Toronto, Ontario, Canada (M.K.K.); Division of Emergency Medicine (C.L.A.) and Division of Respirology (A.S.G.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (D.A.A.); Division of Cardiology, Peter Munk Cardiac Centre and Joint Department of Medical Imaging, University Health Network, Toronto, Ontario, Canada (D.S.L.); College of Pharmacy, Western University of Health Sciences, Pomona, CA (C.A.J.); Women's College Hospital Institute for Health Systems Solutions and Virtual Care, Toronto, Ontario, Canada (R.S.B.); Cardiovascular Division, Women's College Hospital, Toronto, Ontario, Canada (R.S.B., J.A.U.); and Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH (T.A.S.).
出版信息
Circ Cardiovasc Qual Outcomes. 2015 Mar;8(2):204-12. doi: 10.1161/CIRCOUTCOMES.114.001416. Epub 2015 Feb 3.
BACKGROUND
The CArdiovascular HEalth in Ambulatory care Research Team (CANHEART) is conducting a unique, population-based observational research initiative aimed at measuring and improving cardiovascular health and the quality of ambulatory cardiovascular care provided in Ontario, Canada. A particular focus will be on identifying opportunities to improve the primary and secondary prevention of cardiovascular events in Ontario's diverse multiethnic population.
METHODS AND RESULTS
A population-based cohort comprising 9.8 million Ontario adults ≥20 years in 2008 was assembled by linking multiple electronic survey, health administrative, clinical, laboratory, drug, and electronic medical record databases using encoded personal identifiers. The cohort includes ≈9.4 million primary prevention patients and ≈400,000 secondary prevention patients. Follow-up on clinical events is achieved through record linkage to comprehensive hospitalization, emergency department, and vital statistics administrative databases. Profiles of cardiovascular health and preventive care will be developed at the health region level, and the cohort will be used to study the causes of regional variation in the incidence of major cardiovascular events and other important research questions.
CONCLUSIONS
Linkage of multiple databases will enable the CANHEART study cohort to serve as a powerful big data resource for scientific research aimed at improving cardiovascular health and health services delivery. Study findings will be shared with clinicians, policy makers, and the public to facilitate population health interventions and quality improvement initiatives.
背景
门诊护理研究团队中的心血管健康研究小组（CANHEART）正在开展一项独特的、基于人群的观察性研究项目，旨在衡量和改善加拿大安大略省的心血管健康状况以及门诊心血管护理质量。特别关注的是在安大略省多样化的多民族人群中，寻找改善心血管事件一级和二级预防的机会。
方法与结果
通过使用编码个人标识符将多个电子调查、健康管理、临床、实验室、药物和电子病历数据库相链接，组建了一个基于人群的队列，该队列包含2008年安大略省980万年龄≥20岁的成年人。该队列包括约940万一级预防患者和约40万二级预防患者。通过与综合住院、急诊科和人口动态统计管理数据库进行记录链接来实现对临床事件的随访。将在健康区域层面建立心血管健康和预防护理概况，该队列将用于研究主要心血管事件发生率的区域差异原因以及其他重要研究问题。
结论
多个数据库的链接将使CANHEART研究队列成为旨在改善心血管健康和医疗服务提供的科研强大大数据资源。研究结果将与临床医生、政策制定者和公众分享，以促进人群健康干预和质量改进举措。
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