Universität zu Köln

Seleznova, Yana ORCID: 0000-0001-7260-6384, Wein, Bastian ORCID: 0000-0003-1146-6757, Mueller, Dirk, Naumann, Marie ORCID: 0000-0001-8123-5407, Bruder, Oliver, Steffen, Melanie, Windhoevel, Ute, Loeser, Simon, Artmann, Joerg, Fritz, Thomas, Eckardt, Melanie, Stock, Stephanie and Naber, Christoph Kurt (2021). Evaluation of Guideline Adherence for Cardiac Catheterization in Patients With Presumed Obstructive Coronary Artery Disease in Germany (ENLIGHT-KHK) - A Multicentre, Prospective, Observational Study. Cardiovasc. Revascularization Med., 31. S. 19 - 26. SAN DIEGO: ELSEVIER INC. ISSN 1878-0938

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Abstract

Introduction: The diagnosis or exclusion of obstructive stable coronary artery disease (SCAD) in clinical practice is challenging and therefore clinical guidelines provide recommendations on the use of non-invasive and invasive testing. For Germany, data obtained from the OECD and health insurances indicate a potential non-adherence to guideline-recommended diagnostic pathways. However, there is a lack of prospective and reliable evidence for appropriate use of invasive coronary angiography (CA) in Germany. Objective: To provide evidence on the nature and extent of guideline non-adherence in patients undergoing CA with presumed obstructive SCAD in Germany and, to evaluate the clinical and economic consequences of potential deviations in guideline adherence. Methods: ENLIGHT-KHK is a multicentre, prospective observational study recruiting 1500 patients being admitted for CA with presumed obstructive SCAD and exclusion of acute myocardial infarction (DRKS00015638). The primary outcome measure is the adherence to clinical guidelines in the decision-making process for use of CA. Therefore, the patients' diagnostic pathways and adherence to German and European guidelines will be assessed using clinical data, health-claims data, and a patient questionnaire. The primary safety outcome is a composite of myocardial infarction, stroke and all-cause death. Secondary outcome measures are periprocedural complications and costs. Using a decision-analytic model, the clinical and economic impact of observed guideline adherence in clinical practice will be assessed. Potential barriers and facilitators of guideline-adherent decision-making will be evaluated via semi-structured interviews. Conclusions: ENLIGHT-KHK will give insights into the appropriateness of invasive CA in Germany and enable the development of concepts to improve guideline-adherence in the German health-care setting. (C) 2020 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Seleznova, Yana UNSPECIFIED orcid.org/0000-0001-7260-6384 UNSPECIFIED Wein, Bastian UNSPECIFIED orcid.org/0000-0003-1146-6757 UNSPECIFIED Mueller, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Naumann, Marie UNSPECIFIED orcid.org/0000-0001-8123-5407 UNSPECIFIED Bruder, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Steffen, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Windhoevel, Ute UNSPECIFIED UNSPECIFIED UNSPECIFIED Loeser, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Artmann, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Fritz, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Eckardt, Melanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Stock, Stephanie UNSPECIFIED UNSPECIFIED UNSPECIFIED Naber, Christoph Kurt UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-586287
DOI:	10.1016/j.carrev.2020.11.021
Journal or Publication Title:	Cardiovasc. Revascularization Med.
Volume:	31
Page Range:	S. 19 - 26
Date:	2021
Publisher:	ELSEVIER INC
Place of Publication:	SAN DIEGO
ISSN:	1878-0938
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language APPROPRIATE USE CRITERIA; DIAGNOSIS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58628