Carotid artery stenting will serve as model in effort to develop a national registry system
(Bethesda, MD, and Washington, DC) -- The Society for Cardiovascular Angiography and Interventions (SCAI) and the National Committee for Quality Assurance (NCQA) announced today that they will partner to hold a landmark conference addressing key issues surrounding data collection and analysis related to the performance of carotid artery stenting (CAS). The conference, funded by a grant from the Agency for Healthcare Research and Quality (AHRQ), will bring together clinical, methodological, and other experts to explore the best options for coordinating the collection and analysis of data on CAS procedures and their outcomes. The two organizations expect that these efforts will ultimately serve as a model for the safe and effective introduction of other complex technologies and treatments into clinical practice.
"SCAI and NCQA share a dedication to quality in healthcare and the belief that coordinating data collection and analysis is more important than ever with complex procedures that can be competently performed by physicians from a variety of specialties," said Dr. Barry F. Uretsky, president of SCAI and director of the cardiovascular catheterization laboratory and director of the Division of Cardiology at The University of Texas Medical Branch at Galveston. "CAS is among the first of a number of highly complicated procedures to be introduced into the medical armamentarium, and so it makes an ideal case study for our conference."
"The notion of registries as tools for ensuring patient safety and ongoing evaluation of emerging technologies is gaining momentum," said NCQA President Margaret E. O'Kane. "We believe that they also hold potential as tools for clinicians and institutions. To optimize their value, we need to think through such issues as data ownership and validation, governance, and accountability. We look forward to working with SCAI on this effort."
Data Needed to Guide Treatment Decisions, Improve Outcomes
Carotid artery disease is a serious condition in which the arteries in the neck that are the main conduit for blood flow to the brain are narrowed by plaque buildup. This condition is a very significant risk factor for stroke, which causes death and disability among thousands of Americans every year. Carotid artery stenting was introduced into clinical practice in late 2004, offering physicians a new, minimally invasive option for treating the condition. However, CAS is a challenging procedure, as the brain has no tolerance for bits of plaque or debris that may become dislodged during the treatment.
Until recently, CAS was performed only under research protocols. The procedure's high-risk nature, combined with its recent introduction into clinical practice, speak to the urgent need for reliable data that will enable physicians to monitor outcomes, continually enhance treatment protocols, and ensure patient safety. SCAI and NCQA recognized that CAS brings together many of the variables that the medical community will face as new technologies are unveiled. For this reason, the two organizations proposed using CAS as a case study for safely introducing and achieving quality outcomes with new treatments.
"Regardless of the specific procedure, having reliable data about outcomes will help all physicians to make informed treatment recommendations for each individual patient," said SCAI Past President Dr. Michael J. Cowley, professor of medicine at the Medical College of Virginia/Virginia Commonwealth University in Richmond.
One of the major goals of the conference will be to determine the best procedures to put in place for data collection and analysis. "We need to develop processes to help establish that what's going on in the real world is the same as, or different from, what happened in clinical trials with experienced investigators," said Dr. Bonnie H. Weiner, secretary of SCAI and director of interventional cardiology research at St. Vincent Hospital in Worcester, Mass. "It will help identify programs with good outcomes and the factors involved in those outcomes, and it will assist new programs in achieving equally good outcomes."
The conference will explore how various data registries can be integrated and used to play an effective role in optimizing patient care and ensuring quality of care. Some of the issues conference participants will address are technical and operational concerns, such as appropriate integration of data from various data engines, data elements and transmission, verification, and feedback of data.
"It's important that we reach some consensus on the data elements, data definitions, and measuring tools. These need to be consistent so we can evaluate operators and institutions objectively. NCQA, with its long history of collecting and measuring quality, is an excellent nonpartisan partner in this process," said Dr. Christopher U. Cates, chair of the SCAI Board of Governors and director of vascular intervention at Emory Hospitals in Atlanta. "The conference is an important step in realizing goals of measuring and achieving quality. In short, this is medicine standing behind quality."
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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