1. Heartbeat: An ecosystem approach to clinical decision making

    Improving the efficiency of healthcare is essential for reducing healthcare costs. Adherence to evidence-based practice guidelines has the potential to improve health outcomes at lower costs but there are many barriers to consistent implementation of guidelines in clinical practice. Manja ...

  2. Of best intentions and best practices: thinking beyond guidelines

    Why do well-meaning cardiologists deviate from practice guidelines? In their  Heart  paper, Manja and colleagues tackle this timely topic1 and build on their earlier work evaluating drivers of guideline-discordant care.2 In the first phase of this study, cardiologists reviewed case vigne...

  3. Discrete choice experiments: an insight into what patients prefer

    Despite advances in both medicine and technology, cardiovascular disease (CVD) remains a leading cause of premature death and disability throughout the world.1 The WHO includes CVD as one of the non-communicable diseases that is linked to common risk factors that include those that are bot...

  4. Contemporary point of care cardiac troponin testing in suspected acute coronary syndrome

    Around one million patients present to hospital with chest pain every year, accounting for approximately 5% of all emergency department attendances in the UK. However, only one in five patients are found to have had a myocardial infarction.1 Therefore, for several years, there has been a d...

  5. Antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

    This review provides a comprehensive overview of the available data on antithrombotic therapy after transcatheter aortic valve implantation (TAVI). In the absence of large randomised clinical trials, clinical practice is leaning towards evidence reported in other populations. Due to the gr...

  6. Qualitative study of cardiologists’ perceptions of factors influencing clinical practice decisions

    Background Healthcare costs are increasing in the USA and Canada and a substantial portion of health spending is devoted to services that do not improve health outcomes. Efforts to reduce waste by adopting evidence-based clinical practice guideline recommendations have had limited success....

  7. Impact of heart disease on maternal, fetal and neonatal outcomes in a low-resource setting

    Background The burden of pre-existing cardiovascular disease and the contribution to adverse pregnancy outcomes are not robustly quantified, particularly in low-income countries. We aimed to determine both the prevalence of maternal heart disease through active case finding and its attribu...

  8. Individual preferences on the balancing of good and harm of cardiovascular disease screening

    Objective Transition towards value-based healthcare requires insight into what makes value to the individual. The aim was to elicit individual preferences for cardiovascular disease screening with respect to the difficult balancing of good and harm as well as mode of delivery.Methods A dis...

  9. Diagnostic accuracy of the T-MACS decision aid with a contemporary point-of-care troponin assay

    Objectives The rapid turnaround time of point-of-care (POC) cardiac troponin (cTn) assays is highly attractive for crowded emergency departments (EDs). We evaluated the diagnostic accuracy of the Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid with a POC cTn assay.M...

  10. Sexual rehabilitation for cardiac patients with erectile dysfunction: a randomised clinical trial

    Background Sexual dysfunction is common in patients with either ischaemic heart disease (IHD) or implantable cardioverter defibrillator (ICD) and has a negative impact on quality of life. Non-pharmacological treatment options are lacking. The purpose of this trial was to assess the effect ...