Yale School of Medicine, New Haven, Connecticut, USA.
Duke Clinical Research Institute, Durham, North Carolina, USA.
JACC Cardiovasc Interv. 2022 Apr 11;15(7):685-697. doi: 10.1016/j.jcin.2022.01.014.
Transcatheter aortic valve replacement (TAVR) is the standard of care for severe, symptomatic aortic stenosis. Real-world TAVR data collection contributes to benefit/risk assessment and safety evidence for the U.S. Food and Drug Administration, quality evaluation for the Centers for Medicare and Medicaid Services and hospitals, as well as clinical research and real-world implementation through appropriate use criteria. The essential minimum core dataset for these purposes has not previously been defined but is necessary to promote efficient, reusable real-world data collection supporting quality, regulatory, and clinical applications. The authors performed a systematic review of the published research for high-impact TAVR studies and U.S. multicenter, multidevice registries. Two expert task forces, one from the Predictable and Sustainable Implementation of National Cardiovascular Registries/Heart Valve Collaboratory and another from The Society of Thoracic Surgeons/American College of Cardiology TVT (Transcatheter Valve Therapy) Registry convened separately and then met to reconcile a final list of essential data elements. From 276 unique data elements considered, unanimous consensus agreement was achieved on 132 "core" data elements, with the most common reasons for exclusion from the minimum core dataset being burden or difficulty in accurate assessment (36.9%), duplicative information (33.3%), and low likelihood of affecting outcomes (10.7%). After a systematic review and extensive discussions, a multilateral group of academicians, industry representatives, and regulators established 132 interoperable, reusable essential core data elements essential to supporting more efficient, consistent, and informative TAVR device evidence for regulatory submissions, safety surveillance, best practice, and hospital quality assessments.
经导管主动脉瓣置换术(TAVR)是严重、有症状的主动脉瓣狭窄的标准治疗方法。真实世界的 TAVR 数据收集有助于美国食品和药物管理局的获益/风险评估和安全性证据、医疗保险和医疗补助服务中心和医院的质量评估,以及通过适当使用标准进行临床研究和真实世界实施。为此,以前尚未定义用于这些目的的基本最小核心数据集,但这对于促进高效、可重复使用的真实世界数据收集以支持质量、监管和临床应用是必要的。作者对高影响力的 TAVR 研究和美国多中心、多设备注册进行了系统回顾。来自预测和可持续实施国家心血管登记/心脏瓣膜合作组织的两个专家工作组,以及来自胸外科医生协会/美国心脏病学会 TVT(经导管瓣膜治疗)登记处的另一个工作组分别召开会议,然后开会协调最终的基本数据元素列表。在考虑的 276 个独特数据元素中,就 132 个“核心”数据元素达成了一致共识,从最小核心数据集中排除的最常见原因是负担或难以准确评估(36.9%)、信息重复(33.3%)和不太可能影响结果(10.7%)。经过系统审查和广泛讨论,一个由学者、行业代表和监管机构组成的多边团体确定了 132 个可互操作、可重复使用的基本核心数据元素,这些元素对于支持更高效、一致和信息丰富的 TAVR 设备证据至关重要,可用于监管提交、安全性监测、最佳实践和医院质量评估。