Short summary

Despite improved treatment and lower mortality in ischemic heart disease (IHD), disparities remain in access to and benefits of care, as one-size-fits-all does not apply. The project aims to enhance decision-making in IHD treatment through a personalized approach. Using data from the Western Denmark Heart Registry, it includes all patients undergoing cardiac procedures in Region of Southern Denmark from 2002 to 2022. Findings may lead to adjustments in clinical practice for IHD treatment.

Rationale

The treatment of ischemic heart disease (IHD) has seen significant progress over the past decades, with mortality rates nearly halved. Unfortunately, this progress has not benefited all patients equally, leading to major disparities in access to and outcomes of treatment. Several factors may explain this, including that one-size-fits-all does not apply to IHD patients and that the healthcare system does not perform uniformly across clinics, regions, municipalities, and geographies, despite equal access for equal need being a fundamental objective of the Danish healthcare system. The project is conducted as a part of several Ph.D. dissertations. The aim is to inform decision-making regarding IHD on three levels: 1) Clinical choices between alternative strategies for groups of patients (classical epidemiology, effectiveness, and cost-effectiveness). 2) Clinical choices for individual patients (prediction models/personalized medicine). 3) Distribution of treatment across patient groups (disparities) and potential trade-off between level 1 and 2. The project is expected to contribute to specific relevant initiatives, such as assessing whether declining quality may be linked to missing technology, geography, or specific processes. Ultimately, findings may lead to adjustments in clinical practice of IHD treatment.

Description of the cohort

The cohort includes all patients undergoing cardiac procedures in Region of Southern Denmark from January 1st 2002 to December 31st 2022. The patients are identified in the healthcare treatment system Western Denmark Heart Registry, which holds information on all cardiac procedures performed in western Denmark since 1999.

Data and biological material

The dataset holds information on patient- (age, sex etc.), risk- (smoking status, familiar history of IHD etc.), procedure- (indication for the cardiac procedure, procedure time etc.), and care-related data (need for renewed cardiac procedure etc.).

Collaborating researchers and departments

Department of Cardiology, Odense Unoversity hospital

• M.D., DmSci, Ph.D., Professor, Interventional Cardiologist, Lisette Okkels Jensen.
• M.D., Ph.D.-student, Mona El-Faramawi.
• M.D., Marco Busco.

Elite Research Centre for Individualized Medicine, Odense University Hospital

• HD, MSc, MPH, Ph.D., professor of health economics, Rikke Søgaard.

Department of Surgery, University of Minnesota

• BA/BS, MS, Ph.D. assistant professor, Tinen Iles

Publications associated with the project

None yet.