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Primer on Statistical Interpretation or Methods

The Cardiovascular Research Network

A New Paradigm for Cardiovascular Quality and Outcomes Research

Alan S. Go, MD; David J. Magid, MD, MPH; Barbara Wells, PhD; Sue Hee Sung, MPH; Andrea E. Cassidy-Bushrow, PhD; Robert T. Greenlee, PhD, MPH; Robert D. Langer, MD, MPH; Tracy A. Lieu, MD, MPH; Karen L. Margolis, MD, MPH; Frederick A. Masoudi, MD, MSPH; Catherine J. McNeal, MD, PhD; Glen H. Murata, MD; Katherine M. Newton, PhD; Rachel Novotny, PhD, RD; Kristi Reynolds, PhD, MPH; Douglas W. Roblin, PhD; David H. Smith, RPh, MHA, PhD; Suma Vupputuri, PhD; Robert E. White, MD, MPH; Jean Olson, MD, MPH; John S. Rumsfeld, MD, PhD and Jerry H. Gurwitz, MD

From Kaiser Permanente Northern California (A.S.G., S.H.S.), University of California, San Francisco, Calif; Kaiser Permanente Colorado (D.J.M., F.A.M., J.S.R.), University of Colorado, Denver, Colo; National Heart, Lung and Blood Institute (B.W., J.O.), Bethesda, Md; Henry Ford Health System (A.C-B.), Detroit, Mich; Marshfield Clinic Research Foundation (R.T.G.), University of Wisconsin, Madison, Wis; Geisinger Health System (R.D.L.), Danville, Penn; Department of Ambulatory Care and Prevention, Harvard Pilgrim Health Care and Harvard Medical School (T.A.L.), Boston Mass; HealthPartners Research Foundation (K.L.M.), University of Minnesota, Minneapolis, Minn; Denver Health Medical Center (F.A.M.), Denver, Colo; Scott and White (C.J.M.), Temple, Tex; Texas A&M Health Science Center (C.J.M.), Texas A&M University, College Station, Tex; University of New Mexico (G.H.M., R.E.W.), Albuquerque, NM; New Mexico VA Health Care System (G.H.M.), Albuquerque, NM; Group Health (K.M.N.), Seattle, Wash; University of Washington (K.M.N., D.H.S.), Seattle, Wash; Kaiser Permanente Center for Health Research—Hawaii (R.N.), University of Hawaii, Honolulu, Hawaii; Kaiser Permanente Southern California (K.R.), Pasadena, Calif; Kaiser Permanente Georgia (D.W.R., S.V.), Atlanta, Ga; Emory University (D.W.R.), Atlanta, Ga; Kaiser Permanente Northwest (D.H.S.), Portland, Ore; Oregon State University (D.H.S.), Corvallis, Ore; Lovelace Clinic Foundation (R.E.W.), Albuquerque, NM; Denver Veterans Affairs Medical Center (J.S.M.), Denver, Colo; Meyers Primary Care Institute and Fallon Community Health Plan (J.H.G.), Worcester, Mass; and University of Massachusetts (J.H.G.), Amherst, Mass.

Correspondence to Alan S. Go, MD, Division of Research, Kaiser Permanente of Northern California, 2000 Broadway St, 3rd Floor, Oakland, CA 94612-2304. E-mail Alan.S.Go{at}kp.org

Received June 25, 2008; accepted September 16, 2008.

Background— A clear need exists for a more systematic understanding of the epidemiology, diagnosis, and management of cardiovascular diseases. More robust data are also needed on how well clinical trials are translated into contemporary community practice and the associated resource use, costs, and outcomes.

Methods and Results— The National Heart, Lung, and Blood Institute recently established the Cardiovascular Research Network, which represents a new paradigm to evaluate the epidemiology, quality of care, and outcomes of cardiovascular disease and to conduct future clinical trials using a community-based model. The network includes 15 geographically distributed health plans with dedicated research centers, National Heart, Lung, and Blood Institute representatives, and an external collaboration and advisory committee. Cardiovascular research network sites bring complementary content and methodological expertise and a diverse population of 11 million individuals treated through various health care delivery models. Each site’s rich electronic databases (eg, sociodemographic characteristics, inpatient and outpatient diagnoses and procedures, pharmacy, laboratory, and cost data) are being mapped to create a standardized virtual data warehouse to facilitate rapid and efficient large-scale research studies. Initial projects focus on (1) hypertension recognition and management, (2) quality and outcomes of warfarin therapy, and (3) use, outcomes, and costs of implantable cardioverter defibrillators.

Conclusions— The Cardiovascular Research Network represents a new paradigm in the approach to cardiovascular quality of care and outcomes research among community-based populations. Its unique ability to characterize longitudinally large, diverse populations will yield novel insights into contemporary disease and risk factor surveillance, management, outcomes, and costs. The Cardiovascular Research Network aims to become the national research partner of choice for efforts to improve the prevention, diagnosis, treatment, and outcomes of cardiovascular diseases.

Key Words: cardiovascular disease • risk factors • outcomes • epidemiology • quality of care

Guest Editor for this article was Eric D. Peterson, MD.

The opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.

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