Division of Cardiology, Massachusetts General Hospital, Boston (K.R., J.Y.).
Division of Cardiovascular Medicine, Beaumont University Hospital, Corewell Health, Royal Oak, MI (T.R.B.).
Circulation. 2024 Oct;150(14):1140-1150. doi: 10.1161/CIRCULATIONAHA.124.067482. Epub 2024 Sep 12.
Recent advances in therapy and the promulgation of multidisciplinary pulmonary embolism teams show great promise to improve management and outcomes of acute pulmonary embolism (PE). However, the absence of randomized evidence and lack of consensus leads to tremendous variations in treatment and compromises the wide implementation of new innovations. Moreover, the changing landscape of health care, where quality, cost, and accountability are increasingly relevant, dictates that a broad spectrum of outcomes of care must be routinely monitored to fully capture the impact of modern PE treatment. We set out to standardize data collection in patients with PE undergoing evaluation and treatment, and thus establish the foundation for an expanding evidence base that will address gaps in evidence and inform future care for acute PE. To do so, >100 international PE thought leaders convened in Washington, DC, in April 2022 to form the Pulmonary Embolism Research Collaborative. Participants included physician experts, key members of the US Food and Drug Administration, patient representatives, and industry leaders. Recognizing the multidisciplinary nature of PE care, the Pulmonary Embolism Research Collaborative was created with representative experts from stakeholder medical subspecialties, including cardiology, pulmonology, vascular medicine, critical care, hematology, cardiac surgery, emergency medicine, hospital medicine, and pharmacology. A list of critical evidence gaps was composed with a matching comprehensive set of standardized data elements; these data points will provide a foundation for productive research, knowledge enhancement, and advancement of clinical care within the field of acute PE, and contribute to answering urgent unmet needs in PE management. Evidence produced through the Pulmonary Embolism Research Collaborative, as it is applied to data collection, promises to provide crucial knowledge that will ultimately produce a robust evidence base that will lead to standardization and harmonization of PE management and improved outcomes.
治疗方面的最新进展和多学科肺栓塞团队的制定，为改善急性肺栓塞 (PE) 的管理和结果带来了巨大希望。然而，缺乏随机证据和缺乏共识导致治疗方法存在巨大差异，从而影响了新创新的广泛实施。此外，医疗保健领域的格局正在发生变化，质量、成本和问责制越来越重要，这就要求常规监测广泛的护理结果，以充分了解现代 PE 治疗的影响。我们着手规范接受评估和治疗的 PE 患者的数据收集，从而为扩大证据基础奠定基础，该基础将解决证据空白并为急性 PE 的未来护理提供信息。为此，2022 年 4 月，100 多名国际肺栓塞思想领袖在华盛顿特区举行会议，成立了肺栓塞研究合作组织。与会者包括医生专家、美国食品和药物管理局的主要成员、患者代表和行业领导者。认识到 PE 护理的多学科性质，肺栓塞研究合作组织由来自利益相关者医学专业的代表专家组成，包括心脏病学、肺病学、血管医学、重症监护、血液学、心脏外科、急诊医学、医院医学和药理学。制定了一份关键证据空白清单，并附有一套匹配的标准化数据元素；这些数据点将为急性 PE 领域的富有成效的研究、知识增强和临床护理的进步提供基础，并有助于回答 PE 管理中紧迫的未满足需求。通过肺栓塞研究合作组织产生的证据，如其在数据收集方面的应用，有望提供关键知识，最终产生一个强大的证据基础，从而实现 PE 管理的标准化和协调一致，并改善结果。
