Evidence map›Paper›PMID 38877422›Full record

ArticleBMC cardiovascular disorders2024

Data-driven collaborative QUality improvement in Cardiac Rehabilitation (QUICR) to increase program completion: protocol for a cluster randomized controlled trial.

Dion Candelaria, Julie Redfern, Adrienne O'Neil, David Brieger, Robyn A Clark, Tom Briffa, Adrian Bauman, Karice Hyun, Michelle Cunich, Gemma A Figtree and 2 more

Abstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing 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

5 citing papers in PubMed.

  1. Trial
  2. Review
  3. Observational
  4. Review
  5. Impact of cardiac rehabilitation on anxiety, depression, and health-related quality of life in cardiovascular patients.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
    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

12 authors.

Dion CandelariaFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia. dion.candelaria@sydney.edu.au.ORCID 0000-0001-7547-2860
Julie RedfernFaculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
Adrienne O'NeilIMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Deakin University, Barwon Health, Geelong, VIC, Australia.
David BriegerFaculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Robyn A ClarkCaring Futures Institute, Flinders University, Adelaide, SA, Australia.
Tom BriffaSchool of Population and Global Health, The University of Western Australia, Perth, WA, Australia.
Adrian BaumanFaculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.
Karice HyunFaculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia.
Michelle CunichFaculty of Medicine and Health, Central Clinical School, Charles Perkins Centre, The University of Sydney, Boden Initiative, Sydney, NSW, Australia.
Gemma A FigtreeFaculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
Susie CartledgeSchool of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Robyn GallagherFaculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia.

Funding

National Health and Medical Research Council (NHMRC) Investigator Grant GNT2007946NHMRC Emerging Career Fellow 2 GNT2009295NHMRC Emerging Leader1 Fellowship GNT1196724
6 · The paper itself

Abstract

backgroundCoronary heart disease (CHD) is the leading cause of deaths and disability worldwide. Cardiac rehabilitation (CR) effectively reduces the risk of future cardiac events and is strongly recommended in international clinical guidelines. However, CR program quality is highly variable with divergent data systems, which, when combined, potentially contribute to persistently low completion rates. The QUality Improvement in Cardiac Rehabilitation (QUICR) trial aims to determine whether a data-driven collaborative quality improvement intervention delivered at the program level over 12 months: (1) increases CR program completion in eligible patients with CHD (primary outcome), (2) reduces hospital admissions, emergency department presentations and deaths, and costs, (3) improves the proportion of patients receiving guideline-indicated CR according to national and international benchmarks, and (4) is feasible and sustainable for CR staff to implement routinely.

methodsQUICR is a multi-centre, type-2, hybrid effectiveness-implementation cluster-randomized controlled trial (cRCT) with 12-month follow-up. Eligible CR programs (n = 40) and the individual patient data within them (n ~ 2,000) recruited from two Australian states (New South Wales and Victoria) are randomized 1:1 to the intervention (collaborative quality improvement intervention that uses data to identify and manage gaps in care) or control (usual care with data collection only). This sample size is required to achieve 80% power to detect a difference in completion rate of 22%. Outcomes will be assessed using intention-to-treat principles. Mixed-effects linear and logistic regression models accounting for clusters within allocated groupings will be applied to analyse primary and secondary outcomes. DISCUSSION: Addressing poor participation in CR by patients with CHD has been a longstanding challenge that needs innovative strategies to change the status-quo. This trial will harness the collaborative power of CR programs working simultaneously on common problem areas and using local data to drive performance. The use of data linkage for collection of outcomes offers an efficient way to evaluate this intervention and support the improvement of health service delivery. ETHICS: Primary ethical approval was obtained from the Northern Sydney Local Health District Human Research Ethics Committee (2023/ETH01093), along with site-specific governance approvals.

trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12623001239651 (30/11/2023) ( https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=386540&isReview=true ).

Indexed as

Cardiac RehabilitationMulticenter Studies as TopicQuality ImprovementQuality Indicators, Health CareRandomized Controlled Trials as TopicCooperative BehaviorCoronary DiseaseGuideline AdherenceHealth Care CostsHumansNew South WalesTime FactorsTreatment OutcomeVictoriaCardiac rehabilitationCompletionCoronary heart diseaseData-drivenParticipationQuality improvementRandomized controlled trialSecondary prevention

Identifiers

PMID38877422
PMCPMC11177531

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.