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Saint Luke’s Mid America Heart Institute has created an internationally recognized center of excellence in cardiovascular outcomes research, the basic science of health care delivery. Our group has developed and pioneered the international standards for measuring patients’ symptoms, function, and quality of life.
And our tools have been translated into more than 100 languages to measure the outcomes of new treatments and health care from patients’ perspectives. We have leveraged these tools to better understand patients’ outcomes and to determine how we can best tailor therapy to individual patients to optimize their survival, symptom control, and quality of life.
Under the joint direction of John Spertus, M.D., M.P.H., and Carole Decker, R.N., Ph.D., FAHA, CPHQ, the MAHI Outcomes Research program continues to rank as one of the leading programs in cardiovascular outcomes research in the world. Our group has received more than $30 million in funding from the NIH, AHA, and industry to advance the country’s understanding of patient outcomes and to develop better tools for measuring quality of care.
Saint Luke’s currently serves as one of three analytic centers for the American College of Cardiology’s National Cardiovascular Data Registries and regularly contributes to the organization’s efforts to improve the consistency of care and optimize patients’ outcomes.
Saint Luke’s outcomes research also has a national reputation for collaborating with other researchers. We founded the Cardiovascular Outcomes Research Consortium (CORC) in 2001 to engage more than 40 member hospitals to jointly recruit and analyze patients’ care to learn how better treatments tailored to individuals can be rendered. CORC is committed to training the next generation of outcomes researchers and is the training site for a post-doctoral cardiovascular outcomes research fellowship program funded by NIH at the University of Missouri–Kansas City.
Most recently, Saint Luke’s outcomes research has developed the methodology to execute patient-specific estimates of outcomes so that patients and their families can choose treatments most aligned with their goals and values. For example, Saint Luke’s now delivers personalized informed consents for angioplasty, or percutaneous coronary intervention (PCI), to every patient. Using risk-prediction models from the American College of Cardiology, we can now tailor the intensity of treatment to patients’ individual risks and engage them in selecting stents that are most aligned with the treatment goals of each and every patient. This is the first effort to systematically incorporate evidence-based, personalized medicine in routine care to improve the safety and cost-effectiveness of treatment.
- Dr. Spertus and his team published more than 65 peer-reviewed articles on the quality of care and outcomes of patients with cardiovascular disease. Beyond their ongoing efforts to promote the importance of 1) patient-reported outcomes as a means to better integrate patients’ symptoms, 2) function and quality of life as outcomes in clinical trials, 3) quality assessment and shared decision-making, their research has recently focused on the development of an infrastructure to support personalized medicine.
- A nine-center study in the setting of angioplasty was able to support the execution of multivariable risk models from the American College of Cardiology into the flow of routine patient care. This study established that this personalized approach improved patients’ experiences with care, tailored treatment with bleeding avoidance strategies to those who most benefit, reduced bleeding complications and enabled more efficient care with reduced costs. In collaboration with investigators from Saint Luke’s Marion Bloch Neuroscience Institute and the University of California-Los Angeles, this methodology is currently being extended to the treatment of acute ischemic stroke, a historically undertreated condition.
- Dr. Spertus, the Daniel J. Lauer/ University of Missouri Endowed Chair in Metabolism and Vascular Research at Saint Luke’s Hospital of Kansas City, continues to lead an NIH/NHLBI-funded training grant in outcomes research and has collaborated with numerous faculty and trainees throughout the country. The project is in collaboration with University of Missouri – Kansas City. He continues to serve as the deputy editor of Circulation: Quality of Care and Outcomes. In recognition of his long-standing commitment to the field, Dr. Spertus was awarded the American Heart Association’s Distinguished Achievement Award by the Quality of Care and Outcomes Research Council. This award, given only once every three years, recognizes excellence in scholarship, mentorship, and significant contributions to the field.
- MAHI Receives Highly Competitive PCORI grants: MAHI investigators were honored to receive a number of grants to support a broad range of new research efforts in 2013. Two of these grants were awarded to the Cardiovascular Outcomes Research Group and its investigators by the Patient-Centered Outcomes Research Institute (PCORI) — a federally funded program designed to help people make informed health care decisions, and to improve health care delivery and outcomes, by producing and promoting high integrity, evidence-based information that comes from research guided by patients, caregivers, and the broader health care community. One PCORI grant, PORTRAIT, is being co-directed by Kim Smolderen, Ph.D., and Dr. Spertus and will investigate trajectories of clinical and patient-reported outcomes among individuals with peripheral artery disease. The second PCORI-funded project is being co-directed by Adnan Chhatriwalla, M.D. and Dr. Spertus and will investigate the ability of a nurse-led educational intervention to allow patients to make more informed and patient-centered decisions around percutaneous coronary revascularization. Each of these grants was for approximately $1.5 million and will support a range of interconnected projects over a three-year period.