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Our research has informed UK & European guidelines on heart failure
Our research focuses on heart failure in primary care. We explore the burden of heart failure in primary care populations and the impact on patients. We have a particular interest in heart failure diagnosis and screening in primary care settings.
Our work involves the follow up of a well phenotyped cohort and a number of heart failure diagnostic and management studies. The EchoCardiographic Heart Of England Screening (ECHOES) programme represents one of the world’s largest study cohorts exploring heart failure and left ventricular systolic dysfunction. A major re-phenotyping of the entire surviving cohort was done in the ECHOES-X study. Survival analysis from both the ECHOES cohort and routinely collected GP datasets have provided reliable prognostic data.
Linked sub-studies have reported on the reliability of natriuretic peptides (BNP and NT-proBNP) as diagnostic and prognostic indicators of heart failure; quality of life in heart failure; mortality in all cause, all stage heart failure; and delivered data on the potential for screening for heart failure.
An HTA systematic review and IPD meta-analysis of heart failure diagnosis derived a clinical decision rule for patients presenting to primary care with possible heart failure. The REFER diagnostic accuracy study found the tool to be ineffective and questioned the current natriuretic peptide thresholds in national and European guidelines.
Our heart failure diagnostic and prognostic research is ongoing. We have also set up a Priority Setting Partnership with partners at the Universities of Bristol and Cambridge and the James Lind Alliance to establish future research priorities for people with advanced heart failure. We are also examining the role of primary care in the management of patients with HF with preserved ejection fraction (HFpEF) in the Optimise-HFpEF research programme.