Special Issue "Pragmatism and Digitization in Cardiovascular Research"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: 15 January 2024 | Viewed by 1006

Special Issue Editor

Division of Cardiology, Duke University School of Medicine, Durham, NC 27710, USA
Interests: heart failure; cardiometabolics; interventional cardiology; cardiovascular medicine

Special Issue Information

Dear Colleagues,

Results from randomized controlled trials (RCTs) have transformed medicine from a field that was anecdote-driven into one that is evidence-based. However, conventional RCTs can be expensive, time intensive, and complex to conduct. Trial recruitment, participation, and data collection can also burden participants and research personnel. Moreover, the majority of cardiovascular RCTs test interventions in selected populations under explicitly protocol-defined settings, limiting the generalizability of findings. Therefore, the emphasis on the need for increased pragmatism and decentralization of clinical trials has increased recently. In this context, the concept of ‘pragmatism’ addresses concerns regarding the limited generalizability of findings in cardiovascular research, and optimizes effectiveness over efficacy evaluation. Moreover, the use of digital health technologies and embedding of RCTs into existing electronic health record (EHR) systems, registries, or administrative databases can streamline patient recruitment, consent, randomization, follow-up visits, surveillance and adjudication of outcomes.

This Special Issue of Journal of Clinical Medicine will focus on the need for "Pragmatism and Digitization in Cardiovascular Research". Potential topics include, but are not limited to:

  1. Original studies using digital technologies and pragmatic approaches for evidence generation;
  2. Current challenges and potential solutions to the implementation of pragmatism into clinical trials;
  3. Current challenges and potential solutions to the use of digital health technologies in evidence generation;
  4. Leveraging electronic health records or administrative databases for evidence generation;
  5. Outcomes adjudication in clinical trials;
  6. Current landscape of registry-based trials.

We welcome papers that address this broad topic to update its research progress.

Dr. Muhammad Shahzeb Khan
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cardiovascular
  • heart failure
  • cardiometabolic
  • interventional cardiology
  • clinical trials
  • randomized controlled trials (RCTs)
  • pragmatism
  • digitization
  • digital technologies
  • pragmatic design
  • electronic health record (EHR)

Published Papers (1 paper)

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Research

Article
Patient Perspectives on Digital Interventions to Manage Heart Failure Medications: The VITAL-HF Pilot
J. Clin. Med. 2023, 12(14), 4676; https://doi.org/10.3390/jcm12144676 - 14 Jul 2023
Viewed by 502
Abstract
Use of guideline-directed medical therapy (GDMT) for treatment of heart failure with reduced ejection fraction (HFrEF) remains unacceptably low. The purpose of this study was to determine whether a digital health tool can augment GDMT for patients with HFrEF. Participants ≥ 18 years [...] Read more.
Use of guideline-directed medical therapy (GDMT) for treatment of heart failure with reduced ejection fraction (HFrEF) remains unacceptably low. The purpose of this study was to determine whether a digital health tool can augment GDMT for patients with HFrEF. Participants ≥ 18 years old with symptomatic HFrEF (left ventricular ejection fraction ≤ 40%) and with access to a mobile phone with internet were included. Participants were given a blood pressure cuff, instructed in its use, and given regular symptom surveys via cell-phone web-link. Data were transmitted to the Story Health web-based platform, and automated alerts were triggered based on pre-specified vital sign and laboratory data. Health coaches assisted patients with medication education, pharmacy access, and lab access through text messages and phone calls. GDMT titration plans were individually created in the digital platform by local clinicians based on entry vitals and labs. Twelve participants enrolled and completed the study. The median age and LVEF were 52.5 years (IQR, 46.5–63.5) and 25% (IQR, 22.5–35.5), respectively. There were 10 GDMT initiations, 52 up-titrations, and 13 down-titrations. Five participants engaged in focus-group interviews following study completion to understand first-hand perspectives regarding the use of digital tools to manage GDMT. Participants expressed comfort knowing that there were clinicians regularly reviewing their data. This alleviated concerns of uncertainty in daily living, led to an increased feeling of security, and empowered patients to understand decision-making regarding GDMT. Frequent medication changes, and the associated financial impact, were common concerns. Remote titration of GDMT for HFrEF is feasible and appears to be a patient-centered approach to care. Full article
(This article belongs to the Special Issue Pragmatism and Digitization in Cardiovascular Research)
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