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Analyzing the Evidence Base and Value of Contemporary Cardiovascular Care: Cardiac Resynchronization Therapy

Abstract

Background

The US healthcare system is shifting towards a value-based model where two-sided risk is expected. How to incorporate the level of evidence supporting healthcare interventions in such value-based decision making however is unclear. The Cardiology Department within the Duke Health System is currently performing a pilot project where they are delineating the cost/evidence relationship for episodic and longitudinal cardiovascular care. As health systems such as Duke struggle to define value, explore the impact of evidence, and make decisions for treatment strategies given uncertainties, the role of systematic reviews in this process should be explored.

Objective

To use a recently completed systematic review to determine the usefulness of EPC systematic reviews in value-based modeling effort within the Duke Health System.

Methods

The Duke EPC will work with members of the Duke Cardiology Department to evaluate the usefulness of a recent systematic review on cardiac resynchronization therapy (CRT) to their value-based modeling pilot. We will explore opportunities for improvement in the EPC reports to meet the needs of the Health System Team, and will explore how our findings could be generalized beyond the specific CRT report. Outcomes will include: framework for incorporating systematic reviews in this value-based analysis of cardiovascular care, perceived value of the systematic review evidence in the process, and lessons learned regarding incorporating systematic reviews (both barriers/facilitators) to improve evidence use within a learning health system.