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Cardiol Young. 2017 Sep;27(7):1265-1270. doi: 10.1017/S104795111600295X. Epub 2017 Feb 10.

Translating clinical trials into clinical practice: a survey assessing the potential impact of the Pediatric Heart Network Infant Single Ventricle Trial.

Author information

1
1New England Research Institute,Watertown,Massachusetts.
2
2Children's Hospital at Montefiore/Albert Einstein College of Medicine,New York,New York.
3
3National Heart, Lung, and Blood Institute, National Institutes of Health,Bethesda,Maryland.
4
4Boston Children's Hospital,Boston,Massachusetts.
5
5Medical University of South Carolina,Charleston,South Carolina.
6
6Cincinnati Children's Hospital,Cincinnati,Ohio.
7
7The Children's Hospital of Philadelphia,Philadelphia.
8
8Duke University Medical Center,Durham,North Carolina.
9
9Primary Children's Medical Center, University of Utah,Salt Lake City,Utah,United States of America.
10
10The Hospital for Sick Children, University of Toronto,Toronto,Canada.
11
11Medical College of Wisconsin,Milwaukee,Wisconsin.
12
12Columbia University Medical Center,New York, New York,United States of America.

Abstract

BACKGROUND:

A few studies have evaluated the impact of clinical trial results on practice in paediatric cardiology. The Infant Single Ventricle (ISV) Trial results published in 2010 did not support routine use of the angiotensin-converting enzyme inhibitor enalapril in infants with single-ventricle physiology. We sought to assess the influence of these findings on clinical practice.

METHODS:

A web-based survey was distributed via e-mail to over 2000 paediatric cardiologists, intensivists, cardiothoracic surgeons, and cardiac advance practice nurses during three distribution periods. The results were analysed using McNemar's test for paired data and Fisher's exact test.

RESULTS:

The response rate was 31.5% (69% cardiologists and 65% with >10 years of experience). Among respondents familiar with trial results, 74% reported current practice consistent with trial findings versus 48% before trial publication (p<0.001); 19% used angiotensin-converting enzyme inhibitor in this population "almost always" versus 36% in the past (p<0.001), and 72% reported a change in management or improved confidence in treatment decisions involving this therapy based on the trial results. Respondents familiar with trial results (78%) were marginally more likely to practise consistent with the trial results than those unfamiliar (74 versus 67%, p=0.16). Among all respondents, 28% reported less frequent use of angiotensin-converting enzyme inhibitor over the last 3 years.

CONCLUSIONS:

Within 5 years of publication, the majority of respondents was familiar with the Infant Single Ventricle Trial results and reported less frequent use of angiotensin-converting enzyme inhibitor in single-ventricle infants; however, 28% reported not adjusting their clinical decisions based on the trial's findings.

KEYWORDS:

Single-ventricle physiology; angiotensin-converting enzyme inhibitor; physician survey

PMID:
28183375
PMCID:
PMC5721352
DOI:
10.1017/S104795111600295X
[Indexed for MEDLINE]
Free PMC Article

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