International Consortium for Health Outcomes Measurement (ICHOM): Standardized Patient-Centered Outcomes Measurement Set for Heart Failure Patients

Daniel J P Burns, Jason Arora, Oluwakemi Okunade, John F Beltrame, Sabrina Bernardez-Pereira, Marisa G Crespo-Leiro, Gerasimos S Filippatos, Suzanna Hardman, Arno W Hoes, Stephen Hutchison, Mariell Jessup, Tina Kinsella, Michael Knapton, Carolyn S P Lam, Frederick A Masoudi, Hugh McIntyre, Richard Mindham, Louise Morgan, Luuk Otterspoor, Victoria Parker, Hans E Persson, Claude Pinnock, Christopher M Reid, Jillian Riley, Lynne W Stevenson, Theresa A McDonagh, Daniel J P Burns, Jason Arora, Oluwakemi Okunade, John F Beltrame, Sabrina Bernardez-Pereira, Marisa G Crespo-Leiro, Gerasimos S Filippatos, Suzanna Hardman, Arno W Hoes, Stephen Hutchison, Mariell Jessup, Tina Kinsella, Michael Knapton, Carolyn S P Lam, Frederick A Masoudi, Hugh McIntyre, Richard Mindham, Louise Morgan, Luuk Otterspoor, Victoria Parker, Hans E Persson, Claude Pinnock, Christopher M Reid, Jillian Riley, Lynne W Stevenson, Theresa A McDonagh

Abstract

Whereas multiple national, international, and trial registries for heart failure have been created, international standards for clinical assessment and outcome measurement do not currently exist. The working group's objective was to facilitate international comparison in heart failure care, using standardized parameters and meaningful patient-centered outcomes for research and quality of care assessments. The International Consortium for Health Outcomes Measurement recruited an international working group of clinical heart failure experts, researchers, and patient representatives to define a standard set of outcomes and risk-adjustment variables. This was designed to document, compare, and ultimately improve patient care outcomes in the heart failure population, with a focus on global feasibility and relevance. The working group employed a Delphi process, patient focus groups, online patient surveys, and multiple systematic publications searches. The process occurred over 10 months, employing 7 international teleconferences. A 17-item set has been established, addressing selected functional, psychosocial, burden of care, and survival outcome domains. These measures were designed to include all patients with heart failure, whether entered at first presentation or subsequent decompensation, excluding cardiogenic shock. Sources include clinician report, administrative data, and validated patient-reported outcome measurement tools: the Kansas City Cardiomyopathy Questionnaire; the Patient Health Questionnaire-2; and the Patient-Reported Outcomes Measurement Information System. Recommended data included those to support risk adjustment and benchmarking across providers and regions. The International Consortium for Health Outcomes Measurement developed a dataset designed to capture, compare, and improve care for heart failure, with feasibility and relevance for patients and clinicians worldwide.

Keywords: epidemiology; heart failure; quality and outcomes.

Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Figures

Graphical abstract
Graphical abstract
Figure 1
Figure 1
Working Group Teleconference Flow Diagram A flow diagram outlining the decision making process across the 7 teleconferences.
Central Illustration
Central Illustration
The ICHOM Standard Outcome Set for Heart Failure List of outcomes included in the heart failure standard set. ICHOM = International Consortium for Health Outcomes Measurement; KCCQ-12 = Kansas City Cardiomyopathy Questionnaire; N/A = not applicable; NYHA = New York Heart Association; PHQ-2 = Patient Health Questionnaire; PROMIS = Patient-Reported Outcomes Measurement Information System; SOB = shortness of breath.
Figure 2
Figure 2
Sample Timeline for Outcome Measurement Follow-up chronology from entry into the outcome set, including variables to be measured at each time point. PROM = patient-reported outcome measure.

References

    1. World Health Organization Global Status Report on Noncommunicable Diseases 2014. Available at:
    1. Mendis S., Puska P., Norrving B., editors. Global Atlas on Cardiovascular Disease Prevention and Control. World Health Organization; Geneva, Switzerland: 2011.
    1. Mosterd A., Hoes A.W. Clinical epidemiology of heart failure. Heart. 2007;93:1137–1146.
    1. Conrad N., Judge A., Tran J. Temporal trends and patterns in heart failure incidence: a population-based study of 4 million individuals. Lancet. 2017;391:572–580.
    1. Zannad F. Rising incidence of heart failure demands action. Lancet. 2017;391:518–519.
    1. Yancy C.W., Jessup M., Bozkurt B. ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;62:e147–e239.
    1. McKelvie R.S., Moe G.W., Ezekowitz J.A. The 2012 Canadian Cardiovascular Society heart failure management guidelines update: focus on acute and chronic heart failure. Can J Cardiol. 2013;29:168–181.
    1. Ponikowski P., Voors A.A., Anker S.D. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur J Heart Fail. 2016;18:891–975.
    1. Ambrosy A.P., Fonarow G.C., Butler J., for the Task Force Members and Document Reviewers The global health and economic burden of hospitalizations for heart failure: lessons learned from hospitalized heart failure registries. J Am Coll Cardiol. 2014;63:1123–1133.
    1. Lam C.S.P., Anand I., Zhang S. Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. Eur J Heart Fail. 2013;15:928–936.
    1. Lam C.S.P., Teng T.-H.K., Tay W.T. Regional and ethnic differences among patients with heart failure in Asia: the Asian Sudden Cardiac Death in Heart Failure registry. Eur Heart J. 2016;37:3141–3153.
    1. Mackintosh A., Gibbons E., Fitzpatrick R., editors. A Structured Review of Patient-Reported Outcome Measures for People With Heart Failure: An Update 2009. University of Oxford, Oxford, United Kingdom; 2009.
    1. Green C.P., Porter C.B., Bresnahan D.R., Spertus J.A. Development and evaluation of the Kansas City Cardiomyopathy Questionnaire: a new health status measure for heart failure. J Am Coll Cardiol. 2000;35:1245–1255.
    1. Rector T., Kubo S., Cohn J. Patients’ self-assessment of their congestive heart failure: part 2: content, reliability and validity of a new measure, the Minnesota Living with Heart Failure Questionnaire. Heart Fail. 1987;3:198–209.
    1. Guyatt G.H., Nogradi S., Halcrow S., Singer J., Sullivan M.J., Fallen E.L. Development and testing of a new measure of health status for clinical trials in heart failure. J Gen Intern Med. 1989;4:101–107.
    1. Valderas J.M., Ferrer M., Mendívil J., for the Scientific Committee on Patient-Reported Outcomes of the IRYSS Network Development of EMPRO: a tool for the standardized assessment of patient-reported outcome measures. Value Health. 2008;11:700–708.
    1. Garin O., Ferrer M., Pont À. Disease-specific health-related quality of life questionnaires for heart failure: a systematic review with meta-analyses. Qual Life Res. 2009;18:71–85.
    1. Garin O., Herdman M., Vilagut G. Assessing health-related quality of life in patients with heart failure: a systematic, standardized comparison of available measures. Heart Fail Rev. 2014;19:359–367.
    1. Spertus J.A., Jones P.G. Development and validation of a short version of the Kansas City Cardiomyopathy Questionnaire. Circ Cardiovasc Qual Outcomes. 2015;8:469–476.
    1. Health Measures Patient-Reported Outcomes Measurement Information System (PROMIS) Available at:
    1. Patient Health Questionnaire-2 (PHQ-2) Available at:
    1. EuroQol EQ-5D. Available at:
    1. Kroenke K., Spitzer R.L., Williams J.B.W. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41:1284–1292.
    1. McNamara R.L., Spatz E.S., Kelley T.A. Standardized outcome measurement for patients with coronary artery disease: consensus from the international consortium for health outcomes measurement (ICHOM) J Am Heart Assoc. 2015;4
    1. Díaz-Toro F., Verdejo H.E., Castro P.F. Socioeconomic inequalities in heart failure. Heart Fail Clin. 2015;11:507–513.
    1. Porter M.E. What is value in health care? N Engl J Med. 2010;363:2477–2481.
    1. International Consortium for Health Outcomes Measurement . ICHOM; Boston, MA: 2016. Heart Failure Data Collection Reference Guide.
    1. International Consortium for Health Outcomes Measurement Heart Failure: The Standard Set. Available at: Accessed November 19, 2018.

Source: PubMed

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