What are measures of health?

From the Guidelines

Measurements are crucial in healthcare as they provide objective data for decision-making and analysis, and patient-reported health status is a key metric of cardiovascular health, as emphasized by the American Heart Association 1. When considering measurements in the context of healthcare, it's essential to prioritize metrics that directly impact patient outcomes, such as morbidity, mortality, and quality of life.

• The American Heart Association's strategic goals focus on ideal health behaviors and ideal health factors as metrics of cardiovascular health, but also acknowledge the importance of patient-centered care and patient-reported health status 1.
• The selection and evaluation of performance measures for healthcare are critical, and criteria such as importance, feasibility, and reliability should be considered 1.
• The development and implementation of performance measures should be a multiphase process, consisting of construction of the measurement set, assessment of feasibility and reliability of data collection, and measurement of clinicians' performance 1. Some key points to consider when evaluating measurements in healthcare include:
• The use of standardized units and appropriate measuring tools to determine dimensions, amounts, or degrees of something
• The importance of proper calibration and understanding the level of precision needed
• The need to prioritize metrics that directly impact patient outcomes, such as morbidity, mortality, and quality of life
• The consideration of criteria such as importance, feasibility, and reliability when selecting and evaluating performance measures
• The development and implementation of performance measures as a multiphase process, consisting of construction of the measurement set, assessment of feasibility and reliability of data collection, and measurement of clinicians' performance. In conclusion, the most effective approach to measurement in healthcare is to prioritize patient-reported health status and other metrics that directly impact patient outcomes, while also considering the importance of standardized units, proper calibration, and reliability 1.

From the Research

Measures

• The question of measures is not directly addressed in the provided studies, which focus on the comparison of calcium channel blockers with other classes of drugs for hypertension 2, 3, the importance of clinical reasoning in evidence-based medicine 4, and the cardiovascular benefits of combining angiotensin-converting enzyme inhibition with calcium channel blockade 5.
• However, the studies do discuss the measurement of outcomes such as all-cause mortality, major cardiovascular events, stroke, and congestive heart failure in the context of hypertension treatment 2, 3, 5.
• The study on evidence-based policy-making highlights the importance of considering context-specific problems and diverse forms of research in developing countries 6.

Key Findings

• Calcium channel blockers may reduce major cardiovascular events and stroke compared to beta-blockers and angiotensin-converting enzyme inhibitors, but may increase congestive heart failure events compared to diuretics and angiotensin receptor blockers 2, 3.
• Combining a calcium channel blocker with an angiotensin-converting enzyme inhibitor may be more effective in preventing composite cardiovascular events than combining a diuretic with an angiotensin-converting enzyme inhibitor 5.
• Clinical reasoning is essential in evidence-based medicine, as high-quality evidence from randomized controlled trials may be incomplete, contradictory, or absent, and may not apply to individual patients 4.

Study Limitations

• The studies have limitations, such as the lack of robustness of some findings and the need for further trials to confirm the results 2, 3, 5.
• The study on evidence-based policy-making highlights the challenges of applying globally-applicable research to context-specific problem-solving in developing countries 6.