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欧洲心脏病学会心脏衰竭成人护理和结局质量指标更新。欧洲心脏病学会心力衰竭协会。

European Society of Cardiology quality indicators update for the care and outcomes of adults with heart failure. The Heart Failure Association of the ESC.

机构信息

Internal Medicine Clinic III, Cardiology, Angiology and Intensive Care Medicine, Saarland University Hospital, Homburg, Germany.

Hull York Medical School, University of York, York, UK.

出版信息

Eur J Heart Fail. 2024 Sep;26(9):1867-1875. doi: 10.1002/ejhf.3376. Epub 2024 Jul 12.

Abstract

AIMS

To update the European Society of Cardiology (ESC) quality indicators (QIs) for the evaluation of the care and outcomes of adults with heart failure.

METHODS AND RESULTS

The Working Group comprised experts in heart failure including members of the ESC Clinical Practice Guidelines Task Force for heart failure, members of the Heart Failure Association, and a patient representative. We followed the ESC methodology for QI development. The 2023 focused guideline update was reviewed to assess the suitability of the recommendations with strongest association with benefit and harm against the ESC criteria for QIs. All the new proposed QIs were individually graded by each panellist via online questionnaires for both validity and feasibility. The existing heart failure QIs also underwent voting to 'keep', 'remove' or 'modify'. Five domains of care for the management of heart failure were identified: (1) structural QIs, (2) patient assessment, (3) initial treatment, (4) therapy optimization, and (5) patient health-related quality of life. In total, 14 'main' and 3 'secondary' QIs were selected across the five domains.

CONCLUSION

This document provides an update of the previously published ESC QIs for heart failure to ensure that these measures are aligned with contemporary evidence. The QIs may be used to quantify adherence to clinical practice as recommended in guidelines to improve the care and outcomes of patients with heart failure.

摘要

目的

更新欧洲心脏病学会(ESC)质量指标(QIs),以评估心力衰竭成人的护理和结局。

方法和结果

工作组由心力衰竭专家组成,包括 ESC 心力衰竭临床实践指南工作组的成员、心力衰竭协会的成员和一名患者代表。我们遵循 ESC 的 QI 开发方法。对 2023 年重点指南更新进行了审查,以评估与获益和危害关联最强的建议是否符合 ESC 质量指标标准。所有新提出的 QI 都由每位小组成员通过在线问卷进行单独的有效性和可行性评分。现有的心力衰竭 QI 也进行了投票,以“保留”、“删除”或“修改”。确定了心力衰竭管理的五个护理领域:(1)结构性 QI,(2)患者评估,(3)初始治疗,(4)治疗优化,(5)患者健康相关生活质量。总共在五个领域选择了 14 个“主要”和 3 个“次要”QI。

结论

本文件更新了先前发表的 ESC 心力衰竭 QI,以确保这些措施与当代证据保持一致。QI 可用于量化指南推荐的临床实践依从性,以改善心力衰竭患者的护理和结局。

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