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国家登记处对改善心血管疾病护理质量及治疗结果的作用。

The Role of National Registries in Improving Quality of Care and Outcomes for Cardiovascular Disease.

作者信息

Meltzer Seth N, Weintraub William S

机构信息

MEDSTAR HEART AND VASCULAR INSTITUTE, WASHINGTON, DC.

出版信息

Methodist Debakey Cardiovasc J. 2020 Jul-Sep;16(3):205-211. doi: 10.14797/mdcj-16-3-205.

Abstract

Cardiovascular registries play an integral role in providing real-world data on a number of cardiovascular conditions and allowing measurement of quality metrics across a large cohort of patients. Over the past 35 years, the number of cardiovascular registries has skyrocketed, and their use will only continue to grow as data on novel procedures and devices will need to be collected and analyzed. The American College of Cardiology and Society of Thoracic Surgeons Transcatheter Valve Therapy Registry is just one example of a modern registry that plays a crucial role in collecting data on patients undergoing transcatheter valvular procedures. Through public reporting registries, data can be shared on a hospital and provider level for many quality performance measures. There remains much work to be done on allowing automated data extraction from the electronic medical record directly into registries. No matter how sophisticated and complete a registry is, it can never overcome the problem of treatment selection bias that is inherent in observational data. This review discusses the growth, benefits, and limitations of national registries and their role in developing evidence for best clinical practice, measuring outcomes, providing feedback to clinicians, and improving quality of care.

摘要

心血管注册登记在提供多种心血管疾病的真实世界数据以及对大量患者群体的质量指标进行测量方面发挥着不可或缺的作用。在过去35年里,心血管注册登记的数量急剧增加,而且随着新型手术和器械数据需要收集和分析,其应用只会持续增长。美国心脏病学会和胸外科医师学会经导管瓣膜治疗注册登记只是现代注册登记的一个例子,它在收集接受经导管瓣膜手术患者的数据方面发挥着关键作用。通过公开报告注册登记,许多质量绩效指标的数据可以在医院和医疗服务提供者层面共享。在实现从电子病历直接自动提取数据到注册登记方面仍有许多工作要做。无论注册登记多么复杂和完善,它都无法克服观察性数据中固有的治疗选择偏倚问题。本综述讨论了国家注册登记的发展、益处和局限性,以及它们在为最佳临床实践提供证据、测量结果、向临床医生提供反馈和提高医疗质量方面的作用。

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