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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 leadership of John Spertus, M.D., M.P.H., F.A.C.C., F.A.H.A., who has led the program since 1998, Saint Luke’s outcomes research group has grown into one of the nation’s leaders in the field. 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.
In a recent nine-center study (including the Mayo Clinic, Kaiser, Washington University in St. Louis, and Yale University) the personalized consent forms improved patients’ experiences with care, knowledge about the procedure, and participation in shared decision-making. The results were presented as a Late Breaking Clinical Trial at the 2011 American Heart Association’s Scientific Sessions. Saint Luke’s is now working to extend this model to other cardiac and non-cardiac diseases.
- The Saint Luke’s Mid America Heart Institute cardiovascular outcomes research team is training the next generation of outcomes researchers. A total of five fellows have graduated from the SLMAHI AHA-Pharmaceutical Roundtable-Spina Fellowship program in Outcomes Research since 2009. The extraordinary success of these fellows has inspired the team to seek funding to continue the training program. SLMAHI and the University of Missouri–Kansas City (UMKC) collaborated to successfully compete for a new NIH T32 training program grant that began July 1, 2012. Under the direction of John Spertus, M.D., this renewable five-year training grant is the first NIH T32 training grant in the UMKC School of Medicine and will support the training of 10 additional outcomes research fellows over the next five years.
- Saint Luke’s Mid America Heart Institute was awarded one of the first 2012 research grants offered by the congressionally authorized Patient-Centered Outcomes Research Institute (PCORI). A 2012 outcomes research fellow graduate, Kim Smolderen, Ph.D., is leading the PORTRAIT study that will design and test the infrastructure for a study focused on patient-centered outcomes of patients with peripheral arterial disease (PAD). Patients and providers from different centers will help define what outcomes they value the most; how best to develop the screening and research protocol; and how to include a wide variety of patients with PAD.
- The outcomes research team, led by John Spertus, M.D., continues to test the Patient Risk Information Services Manager (PRISM), a novel web-based tool that generates risk estimates and outcomes for individual patients undergoing medical interventions. The team is branching out beyond cardiac therapies and is collaborating with Saint Luke’s Neuroscience Institute and UCLA to refine and implement risk-adjusted models for thrombolytic administration during acute ischemic stroke.
- John Spertus, M.D., continues to direct the Personalized Medicine and Outcomes Research Core (PMOC) for Frontiers—Heartland Institute of Clinical and Translational Research (HICTR), an NIH-funded Clinical and Translational Science Award (CTSA). In 2012, the PMOC expanded its services through:
- Inclusion of Frontiers network members in weekly outcomes research conferences and seminars at SLMAHI
- Enhanced research activities within the metro
- Working to build the Kansas City Quality of Care and Outcomes Research Network with the multi-stakeholder collaboration being organized by the Chamber of Commerce
- Working with the Heartland Health Network to build the infrastructure for community involvement with outcomes researchers
- Collaborating with multiple premier organizations in the Kansas City metropolitan area to improve the care of the community members