Performance and Evaluation of Quality Indicators in the Management of Patients with Heart Failure
Bibliographic record
Abstract
The systematic evaluation of evidence-based quality indicators (QIs) in patients with heart failure (HF) is important to assess the quality of care provided to these patients. Guideline recommended therapies have proven to reduce clinical event rates, however quality of life (QoL) is frequently missed as an endpoint in the measurement of treatment efficacy. We hypothesized that there was high adherence to the Canadian Cardiovascular Society (CCS) outpatient QIs, and the adherence was positively associated with QoL. We evaluated the performance of the outpatient QIs extracted from the CCS recommendations and examined their relationship with patient-reported QoL, measured by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Kansas City Cardiomyopathy Questionnaire (KCCQ). We found that there was high adherence (89%) to evidence-based QIs and patients reported a clinically significant improvement in QoL (>5 points), however, there appears to be no association between the performance of these indicators and patient-reported QoL.\nLa evaluación sistemática de indicadores de calidad basados en evidencia en pacientes con insuficiencia cardiaca (IC) es importante para determinar la calidad de cuidados que se provee a estos pacientes. Las terapias recomendadas por la guías clínicas han demostrado reducir la proporción de eventos clínicos, sin embargo la calidad de vida es frecuentemente omitida como objetivo en la medición de la eficacia de estos tratamientos. Se hipotetizo que había alta adherencia a los indicadores de calidad propuestos por la Sociedad Canadiense de Cardiología (CCS), y que esta adherencia estaba asociada positivamente con la calidad de vida. Se evaluó la ejecución de los indicadores de calidad en el paciente externo extraídos de las recomendaciones del CCS y se examino su relación con la calidad de vida reportada por el paciente, a través del Minnesota Living with Heart Failure Questionnaire (MLHFQ) y el Kansas City Cardiomyopathy Questionnaire (KCCQ). Encontramos que había alta adherencia (89%) a los indicadores de calidad y los pacientes reportaron una mejoría clínicamente significativa en la calidad de vida (> 5 puntos), sin embargo, no parece haber asociación entre la ejecución de estos indicadores y la calidad de vida reportada por los pacientes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.167 | 0.243 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.006 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".