T.M.I. (Too Much Information)?

Udelson, James E.

doi:10.1161/circulationaha.111.067819

Cited by 9 publications

(7 citation statements)

References 23 publications

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“…120 Moreover, it will be key to ensure that neither patients nor care providers fall victim to the too-much-information syndrome, because the density of available information may very well exceed our capacity or knowledge to act on it. 121 For example, despite multiple trials, it remains uncertain how and whether guiding therapy by natriuretic peptide levels improves quality of life or outcomes. The greater incorporation of patients into the circle of care will undoubtedly occur, but it should be firmly constrained by our ability to curate information in a way that enhances optimal management and outcomes.…”

Section: Clinical Teams As Curators Of Informationmentioning

confidence: 99%

The Future of Heart Failure Diagnosis, Therapy, and Management

Udelson

Stevenson

2016

Circulation

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Section: Clinical Teams As Curators Of Informationmentioning

confidence: 99%

The Future of Heart Failure Diagnosis, Therapy, and Management

Udelson

Stevenson

2016

Circulation

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“…21 Unexpectedly, the study recently showed an increased number of hospital admissions in the access arm, and data seemed to suggest that this could be ascribed to the audible alert requiring patientphysician contact for evaluation and possible adjustment of treatment. 27 Nonetheless, the use of implantable hemodynamic monitoring systems was previously demonstrated to be associated with a significant reduction in HF hospitalizations when the hemodynamic information in the access group was provided only to clinicians and patients were blinded. 28,29 Therefore, it could be hypothesized that in the DOT-HF trial, remote monitoring availability could have avoided outpatient visits for the review of diagnostic information, thus reducing healthcare use in the access arm.…”

Section: Landolina Et Almentioning

confidence: 99%

Remote Monitoring Reduces Healthcare Use and Improves Quality of Care in Heart Failure Patients With Implantable Defibrillators

et al. 2012

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Background-Heart failure patients with implantable cardioverter-defibrillators (ICDs) or an ICD for resynchronization therapy often visit the hospital for unscheduled examinations, placing a great burden on healthcare providers. We hypothesized that Internet-based remote interrogation systems could reduce emergency healthcare visits. Methods and Results-This multicenter randomized trial involving 200 patients compared remote monitoring with standard patient management consisting of scheduled visits and patient response to audible ICD alerts. The primary end point was the rate of emergency department or urgent in-office visits for heart failure, arrhythmias, or ICD-related events. Over 16 months, such visits were 35% less frequent in the remote arm (75 versus 117; incidence density, 0.59 versus 0.93 events per year; Pϭ0.005). A 21% difference was observed in the rates of total healthcare visits for heart failure, arrhythmias, or ICD-related events (4.40 versus 5.74 events per year; PϽ0.001). The time from an ICD alert condition to review of the data was reduced from 24.8 days in the standard arm to 1.4 days in the remote arm (PϽ0.001). The patients' clinical status, as measured by the Clinical Composite Score, was similar in the 2 groups, whereas a more favorable change in quality of life (Minnesota Living With Heart Failure Questionnaire) was observed from the baseline to the 16th month in the remote arm (Pϭ0.026). Conclusions-Remote monitoring reduces emergency department/urgent in-office visits and, in general, total healthcare use in patients with ICD or defibrillators for resynchronization therapy. Compared with standard follow-up through in-office visits and audible ICD alerts, remote monitoring results in increased efficiency for healthcare providers and improved quality of care for patients. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00873899.

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“…Evidence-based medicine is defined as the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients. Too much and detailed information may actually be counterproductive in this respect [40]. In conclusion, this study on stable angina pectoris suggests that few and easily available risk markers (fasting blood glucose, serum creatinine and leucocyte counts) are needed for risk prediction in addition to age, sex and clinical history.…”

Section: Discussionmentioning

confidence: 92%