The modified heart team protocol facilitated the revascularization decision-making quality in complex coronary artery disease Article Swipe

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Hanping Ma , Shen Lin , Xi Li , Yang Wang , Weixian Yang , Kefei Dou , Sheng Liu , Zhe Zheng , Yunpeng Ling , Lufeng Zhang , Jian Liu , Yu Chen , Chuan‐Fen Liu , Yuliang Ma , Gang Liu , Chuanyu Gao , Zhaoyun Cheng , Fang Shao , Yuxiao Sun , Xianpei Wang , Datun Qi , Songtao An , Junlong Hu , Ziniu Zhao , Kefei Dou , Yuan Wu , Rong Liu , Weihua Song , Jun Zhang , Jie Zhao , Weixian Yang , Dong Yin , Lei Song , Hanjun Zhao , Fenghuan Hu , Lijian Gao , Jie Qian , Bin Cui , Yan Yang , Xinjin Luo , Ge Gao , Liqing Wang , Jingang Cui , Xian-Qiang Wang , Xiao Hu , Sheng Liu , Zhe Zheng , Lai Wei , Wenjun Ma , Xiaoning Sun , Limin Xia , Junqing Yang , Nianjin Xie , Haojian Dong , Yue Li , Yongtai Gong , Sheng Li , Bo Yu , Shuang Yang , Lei Xing , Guangmin Yang , Tao Chen , Qianli Ma , Lihua Chen , Hongwei Pan , Cheng Xiang , Nianguo Dong , Ming Li , Fei Li , J J Liu , Yuquan He , Ming Bai , Youqi Zhu , Xin Chen , Fuhua Huang , Zhibing Qiu , Zhi–Chun Gu , Qing Zhang , Shuxuan Jin , Yong-ping Du , Lin Han , Yangfeng Tang , Guanxin Zhang , Xiantao Song , Ran Dong , Chenchen Tu , Dongfeng Zhang , Mingduo Zhang , Min Zhang , Zhao Yang , Jubing Zheng , Yue Song , Yang Li , Yong He , Zhigang Liu , LU Wan-li , Jianliang Zhang , Zhengqing Wang , Lianqun Wang , Dongyan Yang ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1093/icvts/ivaf023

OBJECTIVES A lack of standardization in heart team implementation potentially leads to suboptimal decision-making quality, and we previously established a modified heart team protocol to improve the decision-making quality. The present trial was to validate the effect of the modified heart team implementation protocol on improving the decision-making quality versus the conventional protocol in complex coronary artery disease (CAD). METHODS Eligible interventional cardiologists, cardiac surgeons and non-interventional cardiologists were randomly allocated to the intervention or control arm and established 12 heart teams in each arm. The 12 heart teams in each arm were randomly divided into 6 pairs, and 480 historic cases with complex CAD into 6 sets of 80 cases. In each arm, each set of 80 cases was discussed independently by one pair of heart teams, with each case finally receiving two heart team decisions (‘pairwise decisions’). The intervention arm conducted heart team decision-making according to the previously established protocol and the control arm based on guideline recommendations. The primary outcome was the overall percent agreement of the inter-team pairwise decisions. Decision-making appropriateness was further analysed. RESULTS A total of 36 cardiac surgeons, 36 interventional cardiologists and 12 non-interventional cardiologists from 26 centres were enrolled. The overall percent agreement was significantly higher in the intervention arm than the control arm (72.1% vs 65.8%, P = 0.04; kappa 0.51 vs 0.37). Both team-level (19.4% vs 33.0%; P < 0.001) and specialist-level (interventional cardiologists, 19.8% vs 37.7%, P < 0.001; cardiac surgeons, 19.8% vs 28.7%, P < 0.001) inappropriateness rate of decision-making was significantly lower in the intervention arm than the control arm. CONCLUSIONS The modified heart team implementation protocol improved the decision-making quality and appropriateness compared with the guideline-based protocol.

Related Topics

Coronary Artery Disease

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Protocol (science) Coronary artery disease Medicine Cardiology Disease Internal medicine Pathology Alternative medicine

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Type: article
Language: en
Landing Page: https://doi.org/10.1093/icvts/ivaf023
OA Status: diamond
References: 20
Related Works: 10
OpenAlex ID: https://openalex.org/W4407373185

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DOI: https://doi.org/10.1093/icvts/ivaf023

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Title: The modified heart team protocol facilitated the revascularization decision-making quality in complex coronary artery disease

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Language: en

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Publication year: 2025

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Publication date: 2025-02-01

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Authors: Hanping Ma, Shen Lin, Xi Li, Yang Wang, Weixian Yang, Kefei Dou, Sheng Liu, Zhe Zheng, Yunpeng Ling, Lufeng Zhang, Jian Liu, Yu Chen, Chuan‐Fen Liu, Yuliang Ma, Gang Liu, Chuanyu Gao, Zhaoyun Cheng, Fang Shao, Yuxiao Sun, Xianpei Wang, Datun Qi, Songtao An, Junlong Hu, Ziniu Zhao, Kefei Dou, Yuan Wu, Rong Liu, Weihua Song, Jun Zhang, Jie Zhao, Weixian Yang, Dong Yin, Lei Song, Hanjun Zhao, Fenghuan Hu, Lijian Gao, Jie Qian, Bin Cui, Yan Yang, Xinjin Luo, Ge Gao, Liqing Wang, Jingang Cui, Xian-Qiang Wang, Xiao Hu, Sheng Liu, Zhe Zheng, Lai Wei, Wenjun Ma, Xiaoning Sun, Limin Xia, Junqing Yang, Nianjin Xie, Haojian Dong, Yue Li, Yongtai Gong, Sheng Li, Bo Yu, Shuang Yang, Lei Xing, Guangmin Yang, Tao Chen, Qianli Ma, Lihua Chen, Hongwei Pan, Cheng Xiang, Nianguo Dong, Ming Li, Fei Li, J J Liu, Yuquan He, Ming Bai, Youqi Zhu, Xin Chen, Fuhua Huang, Zhibing Qiu, Zhi–Chun Gu, Qing Zhang, Shuxuan Jin, Yong-ping Du, Lin Han, Yangfeng Tang, Guanxin Zhang, Xiantao Song, Ran Dong, Chenchen Tu, Dongfeng Zhang, Mingduo Zhang, Min Zhang, Zhao Yang, Jubing Zheng, Yue Song, Yang Li, Yong He, Zhigang Liu, LU Wan-li, Jianliang Zhang, Zhengqing Wang, Lianqun Wang, Dongyan Yang

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Concepts: Protocol (science), Coronary artery disease, Medicine, Cardiology, Disease, Internal medicine, Pathology, Alternative medicine

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abstract_inverted_index.(72.1%	213
abstract_inverted_index.(CAD).	59
abstract_inverted_index.0.001)	230, 248
abstract_inverted_index.0.001;	240
abstract_inverted_index.0.37).	222
abstract_inverted_index.28.7%,	245
abstract_inverted_index.33.0%;	227
abstract_inverted_index.37.7%,	237
abstract_inverted_index.65.8%,	215
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abstract_inverted_index.specialist-level	232
abstract_inverted_index.inappropriateness	249
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