Evidence map›Paper›PMID 15157278›Full record

ArticleBMC health services research2004

Assessing the impact of heart failure specialist services on patient populations.

Georgios Lyratzopoulos, Gary A Cook, Patrick McElduff, Daniel Havely, Richard Edwards, Richard F Heller

Abstract read
In one paragraph

Article in BMC health services research, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Georgios LyratzopoulosSchool of Epidemiology and Health Sciences, The University of Manchester, M13 9PT, United Kingdom. georgios.lyratzopoulos@man.ac.uk
Gary A Cook
Patrick McElduff
Daniel Havely
Richard Edwards
Richard F Heller

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe assessment of the impact of healthcare interventions may help commissioners of healthcare services to make optimal decisions. This can be particularly the case if the impact assessment relates to specific patient populations and uses timely local data. We examined the potential impact on readmissions and mortality of specialist heart failure services capable of delivering treatments such as b-blockers and Nurse-Led Educational Intervention (N-LEI).

methodsStatistical modelling of prevented or postponed events among previously hospitalised patients, using estimates of: treatment uptake and contraindications (based on local audit data); treatment effectiveness and intolerance (based on literature); and annual number of hospitalization per patient and annual risk of death (based on routine data).

resultsOptimal treatment uptake among eligible but untreated patients would over one year prevent or postpone 11% of all expected readmissions and 18% of all expected deaths for spironolactone, 13% of all expected readmisisons and 22% of all expected deaths for b-blockers (carvedilol) and 20% of all expected readmissions and an uncertain number of deaths for N-LEI. Optimal combined treatment uptake for all three interventions during one year among all eligible but untreated patients would prevent or postpone 37% of all expected readmissions and a minimum of 36% of all expected deaths.

conclusionIn a population of previously hospitalised patients with low previous uptake of b-blockers and no uptake of N-LEI, optimal combined uptake of interventions through specialist heart failure services can potentially help prevent or postpone approximately four times as many readmissions and a minimum of twice as many deaths compared with simply optimising uptake of spironolactone (not necessarily requiring specialist services). Examination of the impact of different heart failure interventions can inform rational planning of relevant healthcare services.

Indexed as

Needs AssessmentOutcome and Process Assessment, Health CareAdrenergic beta-AntagonistsCarbazolesCarvedilolCombined Modality TherapyDecision Support TechniquesEvidence-Based MedicineHeart FailureHospital MortalityHospitals, DistrictHumansModels, StatisticalNurse-Patient RelationsPatient Education as TopicPatient ReadmissionAdrenergic beta-AntagonistsCarbazolesCarvedilolPropanolaminesSpironolactone

Identifiers

PMID15157278
PMCPMC434522

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.