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左心室辅助装置目标治疗的最小数据集:对决策者至关重要的证据。

A minimum dataset for destination therapy with left ventricular assist device: the evidence that matters to decision makers.

作者信息

Puñal-Riobóo Janet, Faraldo Vallés Maria José, Nogueira Uzal Natalia, Patrick Hannah, Varela-Lema Leonor

机构信息

Galician Health Knowledge Agency (Avalia-t ACIS), Santiago de Compostela, Spain.

Pharmacist Public Health Inspector, Galician Department of Health, Santiago de Compostela, Spain.

出版信息

Int J Technol Assess Health Care. 2025 Jan 17;41(1):e8. doi: 10.1017/S0266462325000054.

Abstract

BACKGROUND

Left ventricular assist devices (LVAD) are a therapeutic option in patients with advanced heart failure (HF) not a candidate for cardiac transplant as destination therapy (DT). However, important uncertainties remain regarding the use of LVAD in the long-term in real practice settings. When planning registries, it is important to choose the appropriate outcomes that ensure comparability and reduce the possibility of bias.

AIM

The purpose of this study was to establish a minimum dataset (MDS) that should be collected in all LVAD for DT registries to meet the needs and demands of Health Technology Assessment (HTA) doers and health professionals.

METHODS

To design the MDS for LVAD, a preliminary list of outcome domains and data items were developed attending to the gaps and research needs derived from existing evidence coming from HTA carried out at the European Network of Health Technology Assessment (EUnetHTA) level. The list of data items and domains was agreed upon by all involved HTA organizations and a three-round Delphi was conducted among an experienced panel of cardiologists to rate the importance of the items for measuring uncertainty gaps.

RESULTS

After the three-round Delphi process, the expert panel reached a consensus regarding eighteen outcomes and forty-seven variables divided into seven main domains (safety, effectiveness, patient acceptability, satisfaction, healthcare system impact, pharmaceutical management, and technique-related factors).

CONCLUSIONS

The MDS of outcomes and measures, developed based on research gaps and needs, can allow for standardizing data collection and improving the quality of data for decision making and practice.

摘要

背景

对于不适合心脏移植的晚期心力衰竭(HF)患者,左心室辅助装置(LVAD)是一种作为目标治疗(DT)的治疗选择。然而,在实际临床环境中,LVAD的长期使用仍存在重要的不确定性。在规划注册研究时,选择合适的结局指标以确保可比性并减少偏倚可能性非常重要。

目的

本研究的目的是建立一个最小数据集(MDS),所有用于DT注册研究的LVAD均应收集该数据集,以满足卫生技术评估(HTA)人员和卫生专业人员的需求。

方法

为设计LVAD的MDS,根据欧洲卫生技术评估网络(EUnetHTA)层面开展的HTA现有证据所揭示的差距和研究需求,制定了一份结局领域和数据项的初步清单。所有参与的HTA组织就数据项和领域清单达成一致,并在一组经验丰富的心脏病专家中进行了三轮德尔菲法,以评估这些项目对于衡量不确定性差距的重要性。

结果

经过三轮德尔菲法后,专家小组就18项结局和47个变量达成了共识,这些变量分为七个主要领域(安全性、有效性、患者可接受性、满意度、医疗系统影响、药物管理和技术相关因素)。

结论

基于研究差距和需求制定的结局和测量MDS,可实现数据收集的标准化,并提高用于决策和实践的数据质量。

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