Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology

Sherry-Ann Brown; Abdulaziz Hamid; Erin Pederson; Allen Hanna Bs; Ragasnehith Maddula; Rachel Goodman; Morgan Lamberg; Pedro Caraballo; Peter Noseworthy; Opeoluwa Lukan; Gift Echefu; Generika Berman; Indrajit Choudhuri; Cardio-Oncology Artificial Intelligence Informatics & Precision Equity (CAIPE) and Patient Similarity Algorithms in the Prevention of Cardiovascular Toxicity (PACT) Research Team Investigators

doi:10.1186/s40959-023-00179-w

Simplified rules-based tool to facilitate the application of up-to-date management recommendations in cardio-oncology

Cardiooncology. 2023 Oct 27;9(1):37. doi: 10.1186/s40959-023-00179-w.

Authors

Sherry-Ann Brown^{1

2}, Abdulaziz Hamid³, Erin Pederson³, Allen Hanna Bs⁴, Ragasnehith Maddula³, Rachel Goodman³, Morgan Lamberg³, Pedro Caraballo⁵, Peter Noseworthy⁶, Opeoluwa Lukan⁷, Gift Echefu⁷, Generika Berman⁸, Indrajit Choudhuri⁹; Cardio-Oncology Artificial Intelligence Informatics & Precision Equity (CAIPE) and Patient Similarity Algorithms in the Prevention of Cardiovascular Toxicity (PACT) Research Team Investigators

Affiliations

¹ Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. shbrown@mcw.edu.
² Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA. shbrown@mcw.edu.
³ Medical College of Wisconsin, Milwaukee, WI, USA.
⁴ University of Wisconsin - Milwaukee, Milwaukee, WI, USA.
⁵ Department of Medicine, Mayo Clinic, Rochester, MN, USA.
⁶ Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
⁷ Department of Internal Medicine, Baton Rouge General Medical Center, Baton Rouge, LA, USA.
⁸ Medical College of Wisconsin, Green Bay, WI, USA.
⁹ Department of Electrophysiology, Froedtert South, Kenosha, WI, USA.

Abstract

Background: Millions of cancer survivors are at risk of cardiovascular diseases, a leading cause of morbidity and mortality. Tools to potentially facilitate implementation of cardiology guidelines, consensus recommendations, and scientific statements to prevent atherosclerotic cardiovascular disease (ASCVD) and other cardiovascular diseases are limited. Thus, inadequate utilization of cardiovascular medications and imaging is widespread, including significantly lower rates of statin use among cancer survivors for whom statin therapy is indicated.

Methods: In this methodological study, we leveraged published guidelines documents to create a rules-based tool to include guidelines, expert consensus, and medical society scientific statements relevant to point of care cardiovascular disease prevention in the cardiovascular care of cancer survivors. Any overlap, redundancy, or ambiguous recommendations were identified and eliminated across all converted sources of knowledge. The integrity of the tool was assessed with use case examples and review of subsequent care suggestions.

Results: An initial selection of 10 guidelines, expert consensus, and medical society scientific statements was made for this study. Then 7 were kept owing to overlap and revisions in society recommendations over recent years. Extensive formulae were employed to translate the recommendations of 7 selected guidelines into rules and proposed action measures. Patient suitability and care suggestions were assessed for several use case examples.

Conclusion: A simple rules-based application was designed to provide a potential format to deliver critical cardiovascular disease best-practice prevention recommendations at the point of care for cancer survivors. A version of this tool may potentially facilitate implementing these guidelines across clinics, payers, and health systems for preventing cardiovascular diseases in cancer survivors.

Trial registration: ClinicalTrials.Gov Identifier: NCT05377320.

Keywords: Cancer Survivors; Cardio-oncology; Guidelines; Scientific statements.

Associated data

ClinicalTrials.gov/NCT05377320

Abstract

Associated data

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