The benchmarking system, developed in the EURHOBOP project led by Jaume Marrugat of IMIM – Hospital del Mar Medical Research Institute (Barcelona, Spain), has just been published in the International Journal of Cardiology, one of the top Cardiology scientific journals. This is the first international system that allows the assessment of patient management in acute myocardial infarction (AMI) and Percutaneous Coronary Intervention (PCI) by comparing in-hospital mortality among hospitals with similar characteristics and similar patient profile. This comparison can be done by cardiologists, hospital managers or other healthcare professionals, provided that a sample of acute coronary syndrome (ACS) patients is available. The models were conceived and developed in their first version as a result of the pilot phase of the EUPHORIC project (www.euphoric-project.eu) and, thanks to the important collaborative job of all the participating partners (www.regicor.org/eurhobop_inv), further developed and finalized in the EURHOBOP project, with a cohort of 15,170 ACS patients. Then, they were externally validated, with a cohort of 55,955 European ACS patients, showing good discrimination at patient level and acceptable accuracy at hospital level. Previously, such models had only been available for the US or single European countries, thus lacking the possibility of a cross-European performance assessment. This lack is now covered by the EURHOBOP benchmarking system, a simple and reliable tool that uses multilevel logistic regression to compare in-hospital mortality rates in AMI and PCI by taking into account the country, and hospital- and patient-level variables. The article “R. Degano I, Subirana I, Torre M, Grau M, Vila J, Fusco D, Kirchberger I, Ferrieres J, Malmivaara A, Azevedo A, Meisinger C, Bongard V, Farmakis D, Davoli M, Häkkinen U, Araújo C, Lekakis J, Elosua R, Marrugat J, on behalf of the EURHOBOP investigators. A European benchmarking system to evaluate in-hospital mortality rates in acute coronary syndrome: The EURHOBOP project. International Journal of Cardiology. 2015. doi:10.1016/j.ijcard.2015.01.019. [Epub ahead of print]" is available at the following address: http://www.sciencedirect.com/science/article/pii/S0167527315000443#. Click here to register and be allowed to use the developed functions.
EURHOBOP project has been awarded by the EU Commission has been selected to be one of the 11 European project that will be presented in the cluster meeting “PROMOTING PATIENT SAFETY AND QUALITY OF CARE: The EU contribution to national actions” organized by the Consumers, Health and Food Executive Agency (CHAFEA) in Rome, next 2 and 3 December 2014.
Organized under the auspices of the Italian Presidency of the European Union and with the support of Università Cattolica del Sacro Cuore Facoltà di Medicina e Chirurgia, the specific event is part of a broader strategy of the European Commission to support the dissemination of results of the EU Health Programme. Scheduled to take place one day after the meeting of the EPSCO Council, which will invite Member States to take action in the specific area, it will bring together experts, institutional actors and media at European and National level.
Unlike most of the workshops they organize, this specific meeting is targeted to media from across the EU, and circa 25 journalists are expected to be covering the event, both from mainstream as well as specialized press, with a view to raise awareness of results / impact of EU action in public health to a wider audience.
EURHOBOP will be presented during the 2nd session:
Promoting quality of care across the health: Building the evidence base: how to address quality of care across the health system
In cooperation with the Eurhobop working group, the Research and Prevention on Cardiovascular Diseases group of Toulouse leaded by Jean Ferrières, has recently published in the journal Heart the results of a specific study conducted on the Eurhobop population-based longitudinal cohort aimed to describe the current characteristics of patients admitted for acute coronary syndrome (ACS) in Western Western Europe and to analyse whether international in-hospital mortality variations are explained by differences in patients’ baseline characteristics and in clinical management. The Eurhobop cohort includes 12,231 consecutive ACS patients admitted between 2008 and 2010 in 53 hospitals from Finland, France, Germany, Greece, Portugal and Spain. The study showed that: a) in-hospital mortality rates of STEMI and NSTEMI patients were two to three times higher in Finland, Germany and Portugal than in Greece and Spain, with intermediate values for France, b) differences in baseline characteristics and in clinical management partly explain differences in outcome, c) in-hospital ACS mortality is highly impacted by differences in pre-hospital patient management that are directly related to healthcare system organisation.
The article "André R, Bongard V, Elosua R, Kirchberger I, Farmakis D, Häkkinen U, Fusco D, Torre M, Garel P, Araújo C, Meisinger C, Lekakis J, Malmivaara A, Dovali M, Pereira M, Marrugat J, Ferrières J. International differences in acute coronary syndrome patients' baseline characteristics, clinical management and outcomes in Western Europe: the EURHOBOP study. Heart. 2014 May 1. doi: 10.1136/heartjnl-2013-305196. [Epub ahead of print]" is available at the following address: http://heart.bmj.com/content/early/2014/04/30/heartjnl-2013-305196.full.html.
What is already known about this subject?
Previous population-based registries and large cardiovascular clinical trials highlighted temporal and international differences in acute coronary syndrome (ACS) epidemiology and outcomes. International guidelines have been published to harmonise clinical practice and reduce these variations.
What this study adds?
Despite recent improvements, there are still differences between countries in ACS patients’ presentations and in their clinical management. These lead to significant variations in ACS inhospital mortality, which was paradoxically higher in Northern European countries.
How might this impact on clinical practice?
These results highlight the heterogeneity in ACS management that persists between countries. Moreover, our findings reinforce the need to take pre-hospital mortality into account in further studies on healthcare system efficiency.
An analysis of age and sex inequalities in the prescription of evidence-based pharmacological therapy following an acute coronary syndrome (ACS) in Portugal was published in the European Journal of Preventive Cardiology. The study was conducted within the Eurhobop project as a specific research line of the University of Porto Medical School research group leaded by Ana Azevedo in cooperation with the Municipal Institute of Health Assistance - Municipal Institute of Medical Research that analysed a retrospective cohort of Portuguese patients: 747 episodes of ST-segment elevation myocardial infarction (STEMI) and 1364 of non-ST-segment elevation ACS (NSTE-ACS), within a sample of ACS cases consecutively discharged from 10 Portuguese hospitals in 2008–2009.
The interesting results were that whereas sex had no significant effect on treatment prescription, recommended therapies were substantially underprescribed in older patients. Overall, although the vast majority of patients received evidence-based pharmacological treatment, only half were discharged with the combination of the recommended five drugs.
The article “Pereira M, Araújo C, Dias P, Lunet N, Subirana I, Marrugat J, Capewell S, Bennett K, Azevedo A. Age and sex inequalities in the prescription of evidence-based pharmacological therapy following an acute coronary syndrome in Portugal: the EURHOBOP study. European Journal of Preventive Cardiology published online 20 June 2013 doi: 10.1177/2047487313494580. [Epub ahead of print]" is available at the following address: http://cpr.sagepub.com/content/early/2013/06/18/2047487313494580
A leaflet specifically addressed to the new affiliated collaborating partners giving coincise information on the project, was prepared by the Faculdade de Medicina da Universidade do Porto (FMUP). The leaflet will be distributed during the XXXIII Portuguese Congress of Cardiology that will be held in Vilamoura, Algarve, Portugal from 22 to 24 April 2012.Now available in Portuguese, soon it will be made available in English and in all the language spoken in the project. Click here to download the Portuguese leaflet for the new Affiliated Collaborating Partners.
6 June 2011
1st EURHOBOP External Scientific Advisory Board (ESAB) meeting
The External Scientific Advisory Board (ESAB) of EURHOBOP met on June 6th the in the Helmholz Institute in Munich. The evaluation meeting was organized by Christa Meisinger and Inge Kirchberger, responsible of WP3, in cooperation with the Project coordinator Jaume Marrugat and Yolanda Ferrer.
The aim of the meeting was to judge the performance, achievements and task completion at mid period of the EURHOBOP development.
The EURHOBOP External Scientific Advisory Board (ESAB) is an independent Scientific advisory Committee constituted upon EAHC request during the contract negotiation, to monitor the progress of the project activities with respect to the project schedule approved by the EU Commission, by giving ratings and recommendations to make the project successful.
The members were selected by the project coordinator and the "Evaluation of the project work package (WP3)" leader among a list of public health authorities, clinicians, researchers and epidemiologists proposed by all the project partners.
ESAB is composed by:
- Dr. Ricard Tresserras, Deputy Director for Health Planning at the Department of Health and Social Security of Catalonia in Barcelona (Spain) (EURHOBOP ESAB chairperson)
- Prof. Bernd Brüggenjürgen, of the Institute for Social Medicine, Epidemiology and Health Economics Charité - University Medicine Berlin and Professor at the Steinbeis University of Berlin (Germany)
- Dr. François Paillard, Cardiology Expert at the Centre de Prévention Cardio-vasculaire Pôle TVM, CHU Pontchaillou, Rennes (France)
On the 29-30 June 2010, the European Open Health Forum, under the overall theme of "Together for Health - a Strategy for the EU 2020", was organized in Brussels by Directorate General Health and Consumers.
The aim of the conference was to mark an important step towards strengthening the involvement of all stakeholders in contributing to the development and implementation of actions and activities to protect and improve the health of European citizens. Through the Forum itself the Commission aims at working closely with stakeholder groups, and with regional and local level bodies with a view to optimizing their contribution to the implementation of the EU health strategy.
EURHOBOP was represented in the conference by HOPE that presented the project and distributed the leaflet, getting interest in particular among associations active in the field of cardio-vascular diseases.
To know more visit the Open Health website (http://ec.europa.eu/health/interest_groups/eu_health_forum/open_forum/2010/documents_en.htm#fullwidth)