Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology

Cardio-Oncology

Research

Sherry-Ann Brown¹  Peter Noseworthy²  Indrajit Choudhuri³  Gift Echefu⁴  Opeoluwa Lukan⁴  Pedro Caraballo⁵  Generika Berman⁶  Erin Pederson⁷  Abdulaziz Hamid⁷  Ragasnehith Maddula⁷  Rachel Goodman⁷  Morgan Lamberg⁷  Allen Hanna BS⁸ 

[1] Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA;Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA;Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA;Department of Electrophysiology, Froedtert South, Kenosha, WI, USA;Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA;Department of Medicine, Mayo Clinic, Rochester, MN, USA;Medical College of Wisconsin, Green Bay, WI, USA;Medical College of Wisconsin, Milwaukee, WI, USA;University of Wisconsin - Milwaukee, Milwaukee, WI, USA;

关键词: Guidelines;    Scientific statements;    Cardio-oncology;    Cancer Survivors;   

DOI  :  10.1186/s40959-023-00179-w

 received in 2022-09-10, accepted in 2023-05-24,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundMillions of cancer survivors are at risk of cardiovascular diseases, a leading cause of morbidity and mortality. Tools to potentially facilitate implementation of cardiology guidelines, consensus recommendations, and scientific statements to prevent atherosclerotic cardiovascular disease (ASCVD) and other cardiovascular diseases are limited. Thus, inadequate utilization of cardiovascular medications and imaging is widespread, including significantly lower rates of statin use among cancer survivors for whom statin therapy is indicated.MethodsIn this methodological study, we leveraged published guidelines documents to create a rules-based tool to include guidelines, expert consensus, and medical society scientific statements relevant to point of care cardiovascular disease prevention in the cardiovascular care of cancer survivors. Any overlap, redundancy, or ambiguous recommendations were identified and eliminated across all converted sources of knowledge. The integrity of the tool was assessed with use case examples and review of subsequent care suggestions.ResultsAn initial selection of 10 guidelines, expert consensus, and medical society scientific statements was made for this study. Then 7 were kept owing to overlap and revisions in society recommendations over recent years. Extensive formulae were employed to translate the recommendations of 7 selected guidelines into rules and proposed action measures. Patient suitability and care suggestions were assessed for several use case examples.ConclusionA simple rules-based application was designed to provide a potential format to deliver critical cardiovascular disease best-practice prevention recommendations at the point of care for cancer survivors. A version of this tool may potentially facilitate implementing these guidelines across clinics, payers, and health systems for preventing cardiovascular diseases in cancer survivors.Trial RegistrationClinicalTrials.Gov Identifier: NCT05377320.

【 授权许可】

CC BY   
© The Author(s) 2023

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