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A new set of standard terms and guidelines for data collection developed by the American College of Cardiology (ACC) in Bethesda, MD, is intended to improve the quality of care for cardiac patients.
The Acute Coronary Syndromes (ACS) Clinical Data Standards provide a common terminology for describing the care and outcomes of patients with acute heart conditions, including heart attack and unstable angina. Lack of standardization in terminology and data collection has posed a major obstacle to efforts aimed at improving cardiac care and comparing results of studies, says Ralph Brindis, MD, chief of cardiac services at Kaiser-Permanente in San Francisco.
"The document provides tools and guidance for collecting data in a standardized manner and for comparing different data sets," says Brindis, who also chairs the ACC Task Force on Clinical Data Standards. "At times, medicine seems to operate in a Tower of Babel, where different terms mean different things to different people. By having standard language tools, we will be able to make logical and accurate comparisons in our assessment of the care provided to patients who have ACS," he says.
The standards provide a single definition of a heart attack, for example, which can be used in all clinical trials, Cannon says. Such standardization will permit more accurate and useful comparisons of different studies and data registries. Comparison of cardiac care provided at different hospitals also will become more precise and meaningful.
Uniform standards will permit more accurate evaluation of the type and quality of cardiac care provided to patients and more accurate comparison of findings from studies of treatments for ACS, says Christopher Cannon, MD, a cardiologist at Brigham and Women’s Hosp-ital and Harvard Medical School in Boston and chair of the panel of experts that wrote the ACS standards. "Standardization will help facilitate efforts to improve the quality of cardiac care," Cannon says. "Quality improvement is a major focus of individual hospitals and states as well as on a national level. Collecting accurate data is a major factor in monitoring and improving care. Clear definitions and guidance about how to monitor care should help improve quality."
The ACS standards evolved from an extensive review and discussion of the terminology and methods used in clinical studies, registries of clinical data, and published articles related to the care of patients with ACS. As a primary objective, members of the writing committee sought to identify the best definitions and standards for clinical care and research.
"We have tried to make the definitions as clear as possible and as useful as possible," Cannon says. "We want people to be able to begin using the standards in the development of quality-improvement efforts and new clinical trials and data registries as soon as they are finalized."
The ACS standards are the first in a series of documents the ACC is developing. Brindis says two other writing groups from his task force have begun work on standards for heart failure and atrial fibrillation. The standards are posted on the ACC web site at www.acc.org. After comments are received, a final draft of the standards will be posted on the ACC web site and published in the Journal of the American College of Cardiology.