Acute Myocardial Infarction Setting Priorities for Effectiveness Research (1990) / Chapter Skim
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First was the continued improvement of the clinical and diagnostic information available in the HCFA Medicare data bases for effectiveness research. Specifically, the committee recommended the development of methods that will more accurately identify AMI patients for any effectiveness studies, such methods to involve both the nature and the extent of damage to the heart.
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Second, effectiveness research should examine the methods used to stratify risk in acute AMI and the effect of these methods on patient management and outcomes. The committee recommended the funding of extramural research to validate stratification and triage decision methods that would permit determination of effectiveness in clinically important subsets of patients.
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From page 3... ...
First, the committee recommended that research be supported to identify the effectiveness of specific diagnostic and treatment modalities in the Medicare age group, whether alone or in groupings based on risk stratification methods. Further, they recommended that such investigations start with, but extend beyond, observation of variations of practice patterns and surveillance of specific risk stratification strategies linked to appropriate outcomes.
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From page 4... ...
The committee had concluded that risk stratification methods are not well established and that doing so was a critical patient management issues bow amenable to, and necessary for, effectiveness research. For instance, outcomes of specific competing therapies, such as angioplasty and thrombolysis, might be tracked according to patient subgroups defined by different risk stratification approaches.
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