Circ Cardiovasc Qual
-
Circ Cardiovasc Qual · Nov 2016
Meta Analysis Comparative StudyAnalysis of Machine Learning Techniques for Heart Failure Readmissions.
The current ability to predict readmissions in patients with heart failure is modest at best. It is unclear whether machine learning techniques that address higher dimensional, nonlinear relationships among variables would enhance prediction. We sought to compare the effectiveness of several machine learning algorithms for predicting readmissions. ⋯ Machine learning methods improved the prediction of readmission after hospitalization for heart failure compared with LR and provided the greatest predictive range in observed readmission rates.
-
Circ Cardiovasc Qual · Nov 2016
ReviewIdentifying Important Gaps in Randomized Controlled Trials of Adult Cardiac Arrest Treatments: A Systematic Review of the Published Literature.
Cardiac arrest is a major public health concern worldwide. The extent and types of randomized controlled trials (RCT)-our most reliable source of clinical evidence-conducted in these high-risk patients over recent years are largely unknown. ⋯ Important gaps in RCTs of cardiac arrest treatments exist, especially those examining in-hospital cardiac arrest, protocol improvement, postcardiac arrest care, and long-term or quality-of-life outcomes.
-
Circ Cardiovasc Qual · Nov 2016
Comparative StudySocioeconomic Inequalities in Statin Adherence Under Universal Coverage: Does Sex Matter?
Previous research shows that low socioeconomic position (SEP; especially low income) is associated with statin nonadherence. We investigated the relationship between SEP and statin adherence in a country with universal coverage using group-based trajectory modeling in addition to the proportion of days covered. ⋯ Low SEP was associated with overall and rapidly increasing statin nonadherence among men. Conversely, in women, associations between SEP and nonadherence were weak and inconsistent. Group-based trajectory modeling provided insight into the dynamics of statin adherence and its association with SEP.
-
Circ Cardiovasc Qual · Sep 2016
Randomized Controlled Trial Multicenter Study Comparative StudyRandomized Comparison of High-Sensitivity Troponin Reporting in Undifferentiated Chest Pain Assessment.
High-sensitivity troponin T (hs-TnT) assays promise greater discrimination of evolving myocardial infarction, but the impact of unguided implementation on the effectiveness of care is uncertain. ⋯ URL: http://www.ANZCTR.org.au. Unique identifier: ACTRN12611000879965.
-
Circ Cardiovasc Qual · Sep 2016
Clinical Interventions to Reduce Preventable Hospital Readmission After Percutaneous Coronary Intervention.
Hospital readmissions are common and costly and, in some cases, may be related to problems with care processes. We sought to reduce readmissions after percutaneous coronary intervention (PCI) in a large tertiary care facility through programs to target vulnerabilities predischarge, after discharge, and during re-presentation to the emergency department. During initial hospitalization, we assessed patients' readmission risk with a validated risk score and used a discharge checklist to ensure access to appropriate medications and close follow-up for high-risk patients. ⋯ We tracked the number of patients readmitted after PCI to our hospital. With our interventions, from 2011 to 2015, the index hospital readmission rate has declined from 9.6% to 5.3%. This program could provide tangible structural changes that can be implemented in other healthcare centers, both reducing the cost of care and improving the quality of care for patients with PCI.