Department of Medicine and Duke Clinical Research Institute, Duke University School of Medicine.
U.S. Food and Drug Administration.
Circ J. 2018 Jan 25;82(2):316-322. doi: 10.1253/circj.CJ-17-1156. Epub 2018 Jan 23.
The current state of evaluating patients with peripheral artery disease and more specifically of evaluating medical devices used for peripheral vascular intervention (PVI) remains challenging because of the heterogeneity of the disease process, the multiple physician specialties that perform PVI, the multitude of devices available to treat peripheral artery disease, and the lack of consensus about the best treatment approaches. Because PVI core data elements are not standardized across clinical care, clinical trials, and registries, aggregation of data across different data sources and physician specialties is currently not feasible.Methods and Results:Under the auspices of the U.S. Food and Drug Administration's Medical Device Epidemiology Network initiative-and its PASSION (Predictable and Sustainable Implementation of the National Registries) program, in conjunction with other efforts to align clinical data standards-the Registry Assessment of Peripheral Interventional Devices (RAPID) workgroup was convened. RAPID is a collaborative, multidisciplinary effort to develop a consensus lexicon and to promote interoperability across clinical care, clinical trials, and national and international registries of PVI. The current manuscript presents the initial work from RAPID to standardize clinical data elements and definitions, to establish a framework within electronic health records and health information technology procedural reporting systems, and to implement an informatics-based approach to promote the conduct of pragmatic clinical trials and registry efforts in PVI.
Ultimately, we hope this work will facilitate and improve device evaluation and surveillance for patients, clinicians, health outcomes researchers, industry, policymakers, and regulators.
由于疾病过程的异质性、进行外周血管介入 (PVI) 的多个医师专业、可用于治疗外周动脉疾病的多种设备以及关于最佳治疗方法的共识缺乏,目前评估外周动脉疾病患者、更具体地评估用于外周血管介入的医疗设备仍然具有挑战性。由于 PVI 核心数据元素在临床护理、临床试验和注册中心之间没有标准化,因此目前无法跨不同数据源和医师专业汇总数据。
在美国食品和药物管理局的医疗器械流行病学网络倡议及其 PASSION(国家注册中心可预测和可持续实施)计划的主持下,并结合其他努力使临床数据标准保持一致-注册评估外周介入设备 (RAPID) 工作组召开了会议。RAPID 是一项协作的、多学科的努力,旨在开发共识词汇表,并促进临床护理、临床试验和 PVI 的国家和国际登记处之间的互操作性。本文档介绍了 RAPID 的初步工作,旨在标准化临床数据元素和定义,在电子健康记录和健康信息技术程序报告系统中建立框架,并实施基于信息学的方法,以促进在 PVI 中进行实用临床试验和登记研究。
最终,我们希望这项工作将有助于改善患者、临床医生、健康结果研究人员、行业、政策制定者和监管机构的设备评估和监测。