Dr Rocco Friebel COW 2.09

This course is compulsory on the Executive MSc in Health Economics, Outcomes and Management in Cardiovascular Sciences. This course is not available as an outside option.

Against a backdrop of great technological advances and delivery system innovations, healthcare systems are facing daunting challenges. Over the past half-century, research on cardiovascular diseases has manifested remarkable advances in the prevention and treatment of cardiovascular diseases. Yet, great challenges remain, primarily due to a lack of strong research evidence about how best to improve the quality, outcomes, and efficiency in health systems with a focus on cardiovascular diseases. Outcomes research aims to produce such evidence.

In addition to briefly reviewing key epidemiological trends in cardiovascular diseases in Europe and globally, this course will introduce key 'evidence-practice' gaps in cardiovascular diseases. The first part of the course provides an overview of the definition of quality, its key components, and its measurement in different health care systems. The second part offers a critical perspective on the literature evaluating quality improvement interventions focused on the cardiovascular disease field. The third part focuses on the basics of study design for evaluating quality improvement interventions, programmes, and policies, distinguishing between strong and weak research designs.

The intended learning outcomes of this course are the following:

• Describe the epidemiological trends in cardiovascular disease
• Summarise the primary components of quality in health care
• Explain the main limitations of the literature evaluating quality improvement interventions
• Define the principal threats to validity in studies evaluating quality
• Design an evaluation strategy for a quality improvement policy or intervention in a group setting
• Critically evaluate empirical evaluations of quality and outcomes in health care research in oral and written form

The course will be delivered in no less than 24 hours and comprises lectures and seminars

Formative feedback on group presentations

Krumholz HM. Outcomes research: generating evidence for best practice and policies. Circulation 2008;118:309–18.

Ellwood PM. Shattuck lecture – outcomes management: a technology of patient experience. N Engl J Med 1988; 318: 1549–56.

Clancy CM et al. Outcomes research: measuring the end results of health care. Science 1998; 282: 245–46.

McGlynn EA. Six challenges in measuring the quality of health care. Health Affairs 1997;16.3:7–21.

Chalkidou et al. Comparative effectiveness research and evidence-based health policy: experience from four countries. Milbank Quarterly 2009:87.2: 339–67.

Cook TD. et al (1979). Quasi-experimentation: Design and Analysis Issues for Field settings. Boston, MA: Houghton Mifflin Company.

Concato J et al. Randomized, controlled trials, obser vational studies, and the hierarchy of research designs. N Engl J Med. 2000;342:1887–92.

Essay (100%, 3000 words) in the ST.

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