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Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients.

Publication ,  Journal Article
Al-Khatib, SM; Gierisch, JM; Crowley, MJ; Coeytaux, RR; Myers, ER; Kendrick, A; Sanders, GD
Published in: J Gen Intern Med
December 2015

BACKGROUND: Although the implantable cardioverter-defibrillator (ICD) is highly effective therapy for preventing sudden cardiac death, there is considerable uncertainty about its benefits and harms in older patients, especially in the presence of factors, other than old age, that increase the risk of death. OBJECTIVE: To develop a prioritized research agenda for the Patient-Centered Outcomes Research Institute as informed by a diverse group of stakeholders on the use and outcomes of the ICD in older patients. DESIGN: The existing literature was reviewed to identify evidence gaps, which were then refined by engaged stakeholders. Using a forced-ranking prioritization method, the stakeholders ranked evidence gaps by importance. For the highest-ranked evidence gaps, relevant recent studies were identified using PubMed, and relevant ongoing trials were identified using ClinicalTrials.gov. PARTICIPANTS: Eighteen stakeholders, including clinical experts and researchers in the prevention of sudden cardiac death and ICD therapy, representatives from federal and non-governmental funding agencies, representatives from relevant professional societies, health care decision-makers and policymakers, and representatives from related consumer and patient advocacy groups KEY RESULTS: The top 12 evidence gaps prioritized by stakeholders were related to the safety and effectiveness of ICDs in older patient subgroups not well represented in clinical trials, predictors of SCD, the impact of the ICD on quality of life, the use of shared decision-making, disparities in ICD use, risk stratification strategies, patient preferences, and distribution of modes of death in older patients. CONCLUSIONS: In this paper, we identify evidence gaps of high priority for current and future investigations of ICD therapy. Addressing these gaps will likely resolve many of the uncertainties surrounding the use and outcomes of the ICD in older patients seen in clinical practice.

Duke Scholars

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

December 2015

Volume

30

Issue

12

Start / End Page

1812 / 1820

Location

United States

Related Subject Headings

  • Risk Factors
  • Patient Preference
  • Patient Outcome Assessment
  • Humans
  • General & Internal Medicine
  • Evidence-Based Medicine
  • Electric Countershock
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Biomedical Research
 

Citation

APA
Chicago
ICMJE
MLA
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Al-Khatib, S. M., Gierisch, J. M., Crowley, M. J., Coeytaux, R. R., Myers, E. R., Kendrick, A., & Sanders, G. D. (2015). Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients. J Gen Intern Med, 30(12), 1812–1820. https://doi.org/10.1007/s11606-015-3411-6
Al-Khatib, Sana M., Jennifer M. Gierisch, Matthew J. Crowley, Remy R. Coeytaux, Evan R. Myers, Amy Kendrick, and Gillian D. Sanders. “Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients.J Gen Intern Med 30, no. 12 (December 2015): 1812–20. https://doi.org/10.1007/s11606-015-3411-6.
Al-Khatib SM, Gierisch JM, Crowley MJ, Coeytaux RR, Myers ER, Kendrick A, et al. Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients. J Gen Intern Med. 2015 Dec;30(12):1812–20.
Al-Khatib, Sana M., et al. “Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients.J Gen Intern Med, vol. 30, no. 12, Dec. 2015, pp. 1812–20. Pubmed, doi:10.1007/s11606-015-3411-6.
Al-Khatib SM, Gierisch JM, Crowley MJ, Coeytaux RR, Myers ER, Kendrick A, Sanders GD. Future Research Prioritization: Implantable Cardioverter-Defibrillator Therapy in Older Patients. J Gen Intern Med. 2015 Dec;30(12):1812–1820.
Journal cover image

Published In

J Gen Intern Med

DOI

EISSN

1525-1497

Publication Date

December 2015

Volume

30

Issue

12

Start / End Page

1812 / 1820

Location

United States

Related Subject Headings

  • Risk Factors
  • Patient Preference
  • Patient Outcome Assessment
  • Humans
  • General & Internal Medicine
  • Evidence-Based Medicine
  • Electric Countershock
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Biomedical Research