## Protocol Section
### Identification Module
**NCT ID:** NCT00303979

**Acronym:** IMPROVE-HF

**Brief Title:** IMPROVE HF: Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting

**Official Title:** Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting

#### Organization Study ID Info
**ID:** 258
#### Organization
**Class:** INDUSTRY
**Full Name:** Medtronic Cardiac Rhythm and Heart Failure
### Status Module
#### Completion Date
**Date:** 2009-08

**Type:** ACTUAL

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2019-01-31

**Type:** ACTUAL

**Last Update Submit Date:** 2019-01-29

**Overall Status:** COMPLETED

#### Primary Completion Date
**Date:** 2009-08

**Type:** ACTUAL

#### Results First Post Date
**Date:** 2012-12-27

**Type:** ESTIMATED

**Results First Submit Date:** 2012-11-21

**Results First Submit QC Date:** 2012-11-21

#### Start Date
**Date:** 2005-05

**Status Verified Date:** 2019-01

#### Study First Post Date
**Date:** 2006-03-17
**Type:** ESTIMATED
**Study First Submit Date:** 2006-03-15
**Study First Submit QC Date:** 2006-03-15
### Sponsor Collaborators Module

#### Collaborators

**Class:** INDUSTRY

**Name:** Medtronic

#### Lead Sponsor

**Class:** INDUSTRY

**Name:** Medtronic Cardiac Rhythm and Heart Failure

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Oversight Has DMC:** False

### Description Module

**Brief Summary:** The purpose of this study is to characterize current management of patients with either heart failure or prior myocardial infarction and left ventricular dysfunction and to assess the effect of education, specific clinical guidelines, reminder systems, comprehensive disease state management tools, benchmarked quality reports, and academic detailing on the use of evidence-based heart failure therapies in cardiology practices. This study is a quality improvement initiative that is being conducted through review of patient records.

**Detailed Description:** IMPROVE HF, the largest US outpatient HF patient registry, has substantially contributed to our knowledge of how systolic HF and post MI left ventricular systolic dysfunction (LVSD) patients are treated in the outpatient setting.

The findings of IMPROVE HF clearly support this guideline and may help to establish a model framework for future performance improvement programs for outpatient cardiology practices.

### Conditions Module

**Conditions:**

- Heart Failure, Congestive

- Myocardial Infarction

- Ventricular Dysfunction, Left

**Keywords:**

- Systolic Heart Failure

- Quality of Care

- Outcomes

- Evidence-based Guidelines

- Recommended Therapies

### Design Module

#### Design Info

**Observational Model:** COHORT

**Time Perspective:** PROSPECTIVE

#### Enrollment Info

**Count:** 34810

**Type:** ACTUAL

**Study Type:** OBSERVATIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** Longitudinal Cohort: Approximately 15,000 patients followed at baseline, 12 months and 24 months

**Label:** Cohort A (longitudinal)

#### Arm Group 2

**Description:** 6 Month Cohort: Approximately 10,000 patients reviewed at single time point

**Label:** Cohort B (6 Month)

#### Arm Group 3

**Description:** 18 Month Cohort: Approximately 10,000 patients reviewed at single time point

**Label:** Cohort C (18 Month)

### Outcomes Module

#### Primary Outcomes

**Description:** 7 performance measures: angiotensin converting enzyme inhibitor and/or angiotensin II receptor blockers (ACEI/ARB), beta-blokers, aldosterone receptor antagonists, anticoagulation for atrial fibrillation (AF), cardiac resynchronization therapy (CRT-P/CRT-D), cardioverter-defibrillator (ICD/CRT-D), heart failure (HF) education.

We first calcuated % of patients who were eligible for a performance measure that were treated by it at baseline and 24 months. We then calculated the relative change as (% treated at 24 months - % treated at baseline)/% treated at baseline. The 95% confidence interval (CI) was calculated and the relative change of each performance measure was evaluated using a z-test for one-sample proportion.

The number of performance measures with \>= 20% relative improvement was determined. The intervention was considered successful if a relative 20% or greater improvement in at least 2 of the 7 performance measures at 24 months compared with baseline was achieved.

**Measure:** To Evaluate Over the Aggregate IMPROVE-HF Practice Sites the Relative Changes in 7 Performance Measures at 24 Months Compared With Baseline and Determine the Number of Performance Measures That Achieved a Relative 20% or Greater Positive Change.

**Time Frame:** 24 Month

#### Secondary Outcomes

**Description:** The number of practices that achieved greater than or equal to 20% improvement in two or more of the 7 performance measures at 24 months as compared to baseline of cohort A is presented.

**Measure:** Observe the Number of Sites That Demonstrate a Relative 20% or Greater Improvement in 2 or More of the 7 Performance Measures at 24 Months as Compared to Baseline in Cohort A.

**Time Frame:** 24 months

**Description:** performance measure improvement for each performance measure was analyzed at a practice level from baseline to 24 months. Performance measure adherence was calculated at the individual practice level and then combined and summarized. Mean, standard deviation, and 95% confidence intervals for performance measure adherence, composite score and relative change (24 months compared with baseline) are reported.

The Composite Score is based on the ratio of the sum of the numerators of all individual performance measures to the sum of the denominators of all individual performances measures. The numerator of a performance measure is the number of patients treated with that measure. The denomiator of a performance measure is the number of patients eligible for being treated with that measure.

**Measure:** Observe the Change From Baseline to 24 Months in Each Performance Measure and Composite Score for the Aggregate Practices.

**Time Frame:** 24 months

**Description:** The relative changes between baseline of cohort A and 6 months of cohort B in performance measures and composite score for the aggregate practices were calculated using mean, standard deviation and 95% CI.

**Measure:** Observe the Relative Change Between Baseline of Cohort A and 6 Months of Cohort B in Performance Measures and Composite Score for the Aggregate Practices.

**Time Frame:** Baseline and 6 Months

**Description:** The relative changes between baseline of cohort A and 18 months of cohort C in performance measures and composite score for the aggregate practices were calculated using mean, standard deviation and 95% CI.

**Measure:** Observe the Relative Change Between Baseline of Cohort A and 18 Months of Cohort C in Performance Measures and Composite Score for the Aggregate Practices.

**Time Frame:** baseline and 18 Months

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

* 18 years of age or older
* Primary or secondary diagnosis of heart failure or prior myocardial infarction (heart attack)
* Moderate-to-severe left ventricular dysfunction (LVD) as demonstrated by an ejection fraction \< or = 35% and/or a qualitative assessment of LVD of moderate-to-severe or severe LVD
* Patient has been seen at the clinic at least twice in the past 2 years
* Patient received care from the physician participating in the study

Exclusion Criteria:

* Patient has died
* Patient is not expected to survive for 12 months due to medical conditions other than heart failure
* Patient has undergone heart transplant surgery

**Minimum Age:** 18 Years

**Sampling Method:** PROBABILITY_SAMPLE

**Sex:** ALL

**Standard Ages:**

- ADULT

- OLDER_ADULT

**Study Population:** Heart failure patients in outpatient cardiology practices

### Contacts Locations Module

#### Locations

**Location 1:**

**City:** Birmingham

**Country:** United States

**Facility:** Cardiovascular Associates of Montclair

**State:** Alabama

**Zip:** 36608

**Location 2:**

**City:** Mobile

**Country:** United States

**Facility:** Cardiology Associates

**State:** Alabama

**Zip:** 36608

**Location 3:**

**City:** Mesa

**Country:** United States

**Facility:** Cardiovascular Associates of Mesa

**State:** Arizona

**Zip:** 85205

**Location 4:**

**City:** Scottsdale

**Country:** United States

**Facility:** Heart Care, PC

**State:** Arizona

**Zip:** 85258

**Location 5:**

**City:** Tucson

**Country:** United States

**Facility:** Southern Arizona VA Health Care System

**State:** Arizona

**Zip:** 85723

**Location 6:**

**City:** Hot Springs

**Country:** United States

**Facility:** Central Arkansas Cardiovascular Institute

**State:** Arkansas

**Zip:** 71913

**Location 7:**

**City:** Little Rock

**Country:** United States

**Facility:** Arkansas Cardiology Clinic

**State:** Arkansas

**Zip:** 72202

**Location 8:**

**City:** Fullerton

**Country:** United States

**Facility:** St. Jude Heritage Medical Group

**State:** California

**Zip:** 92835

**Location 9:**

**City:** La Jolla

**Country:** United States

**Facility:** Scripps Clinic Green Hospital

**State:** California

**Zip:** 92037

**Location 10:**

**City:** Los Angeles

**Country:** United States

**Facility:** Veterans Administration Hospital

**State:** California

**Zip:** 92357

**Location 11:**

**City:** Los Angeles

**Country:** United States

**Facility:** University Cardiovascular Medical Group

**State:** California

**Zip:** 94115

**Location 12:**

**City:** Monterey

**Country:** United States

**Facility:** Cardio-Pulmonary Associates

**State:** California

**Zip:** 93940

**Location 13:**

**City:** Murrieta

**Country:** United States

**Facility:** Temecula Valley Cardiology

**State:** California

**Zip:** 92562

**Location 14:**

**City:** San Francisco

**Country:** United States

**Facility:** California Pacific Cardiovascular Medical

**State:** California

**Zip:** 94115

**Location 15:**

**City:** San Pablo

**Country:** United States

**Facility:** East Bay Cardiology

**State:** California

**Zip:** 94803

**Location 16:**

**City:** Tarzana

**Country:** United States

**Facility:** Cardiology Consultants Medical Group

**State:** California

**Zip:** 91335

**Location 17:**

**City:** Fort Collins

**Country:** United States

**Facility:** Medical Center of the Rockies

**State:** Colorado

**Zip:** 80521

**Location 18:**

**City:** Bridgeport

**Country:** United States

**Facility:** Connecticut Heart & Vascular Center

**State:** Connecticut

**Zip:** 06606

**Location 19:**

**City:** Newark

**Country:** United States

**Facility:** Cardiology Consultants, PA

**State:** Delaware

**Zip:** 19702

**Location 20:**

**City:** Bradenton

**Country:** United States

**Facility:** Heart and Vascular Center of Bradenton

**State:** Florida

**Zip:** 34209

**Location 21:**

**City:** Clearwater

**Country:** United States

**Facility:** Clearwater Cardiovascular & Intervention

**State:** Florida

**Zip:** 33756

**Location 22:**

**City:** Clearwater

**Country:** United States

**Facility:** Mahesh Amin, MD PA

**State:** Florida

**Zip:** 33756

**Location 23:**

**City:** Hudson

**Country:** United States

**Facility:** Pasco Cardiology

**State:** Florida

**Zip:** 34667

**Location 24:**

**City:** Kissimmee

**Country:** United States

**Facility:** Cardiovascular Associates

**State:** Florida

**Zip:** 34741

**Location 25:**

**City:** Lakeland

**Country:** United States

**Facility:** Clark and Daughtrey Medical Group

**State:** Florida

**Zip:** 33803

**Location 26:**

**City:** Melbourne

**Country:** United States

**Facility:** OMNI

**State:** Florida

**Zip:** 32901

**Location 27:**

**City:** Miami

**Country:** United States

**Facility:** Miami Cardiology Group

**State:** Florida

**Zip:** 33176

**Location 28:**

**City:** Orlando

**Country:** United States

**Facility:** Florida Heart Group

**State:** Florida

**Zip:** 32803

**Location 29:**

**City:** Port Charlotte

**Country:** United States

**Facility:** Cardiology Associates

**State:** Florida

**Zip:** 33952

**Location 30:**

**City:** Tamarac

**Country:** United States

**Facility:** Cardiovascular Consultants,

**State:** Florida

**Zip:** 33309

**Location 31:**

**City:** Vero Beach

**Country:** United States

**Facility:** Indian River Cardiovascular Associate

**State:** Florida

**Zip:** 32960

**Location 32:**

**City:** Zephyrhills

**Country:** United States

**Facility:** Florida Medical Clinic

**State:** Florida

**Zip:** 33542

**Location 33:**

**City:** Atlanta

**Country:** United States

**Facility:** Cardiology of Atlanta

**State:** Georgia

**Zip:** 30342

**Location 34:**

**City:** Atlanta

**Country:** United States

**Facility:** Northside Cardiology

**State:** Georgia

**Zip:** 30342

**Location 35:**

**City:** Gainesville

**Country:** United States

**Facility:** Northeast Georgia Heart Center

**State:** Georgia

**Zip:** 30501

**Location 36:**

**City:** Savannah

**Country:** United States

**Facility:** Southcoast Cardiology

**State:** Georgia

**Zip:** 31406

**Location 37:**

**City:** Honolulu

**Country:** United States

**Facility:** Pacific Cardiology

**State:** Hawaii

**Zip:** 96817

**Location 38:**

**City:** Boise

**Country:** United States

**Facility:** St. Luke's Idaho Cardiology Associates

**State:** Idaho

**Zip:** 83702

**Location 39:**

**City:** Blue Island

**Country:** United States

**Facility:** Heart Care Center of Illinois

**State:** Illinois

**Zip:** 60406

**Location 40:**

**City:** Frankfort

**Country:** United States

**Facility:** MidAmerica Cardiovascular Consultants

**State:** Illinois

**Zip:** 60453

**Location 41:**

**City:** Glenview

**Country:** United States

**Facility:** Cardiovascular Associates of Glenbrook and Evanston, LLC

**State:** Illinois

**Zip:** 60026

**Location 42:**

**City:** Indianapolis

**Country:** United States

**Facility:** St. Vincent's Hospital

**State:** Indiana

**Zip:** 46201

**Location 43:**

**City:** Indianapolis

**Country:** United States

**Facility:** Methodist Hospital

**State:** Indiana

**Zip:** 46202

**Location 44:**

**City:** Indianapolis

**Country:** United States

**Facility:** St. Vincent's Hospital Indianapolis

**State:** Indiana

**Zip:** 46278

**Location 45:**

**City:** Indianapolis

**Country:** United States

**Facility:** St. Vincent's Hospital,

**State:** Indiana

**Zip:** 46278

**Location 46:**

**City:** West Des Moines

**Country:** United States

**Facility:** Iowa Heart Center PC,

**State:** Iowa

**Zip:** 50266

**Location 47:**

**City:** Kansas City

**Country:** United States

**Facility:** Mid America Cardiology

**State:** Kansas

**Zip:** 66102

**Location 48:**

**City:** Topeka

**Country:** United States

**Facility:** Cardiology Consultants

**State:** Kansas

**Zip:** 66102

**Location 49:**

**City:** Wichita

**Country:** United States

**Facility:** Cardiovascular Consultants of Kansas

**State:** Kansas

**Zip:** 67226

**Location 50:**

**City:** Louisville

**Country:** United States

**Facility:** Louisville Cardiology Medical Group P.S

**State:** Kentucky

**Zip:** 40026

**Location 51:**

**City:** Louisville

**Country:** United States

**Facility:** Medical Center Cardiologists P.S.C

**State:** Kentucky

**Zip:** 40201

**Location 52:**

**City:** Louisville

**Country:** United States

**Facility:** Louisville Cardiology Medical Group P.S

**State:** Kentucky

**Zip:** 40207

**Location 53:**

**City:** Owensboro

**Country:** United States

**Facility:** Owensboro Heart and Vascular

**State:** Kentucky

**Zip:** 42303

**Location 54:**

**City:** Covington

**Country:** United States

**Facility:** Tchefuncte Cardiovascular Associates,

**State:** Louisiana

**Zip:** 70433

**Location 55:**

**City:** Marrero

**Country:** United States

**Facility:** Heart Clinic of Louisiana

**State:** Louisiana

**Zip:** 70072

**Location 56:**

**City:** Bethesda

**Country:** United States

**Facility:** Maryland Heart, PC

**State:** Maryland

**Zip:** 20817

**Location 57:**

**City:** Clinton

**Country:** United States

**Facility:** Heart Center of Southern Maryland

**State:** Maryland

**Zip:** 20735

**Location 58:**

**City:** Glen Burnie

**Country:** United States

**Facility:** Arundel Heart Associates

**State:** Maryland

**Zip:** 21061

**Location 59:**

**City:** Salisbury

**Country:** United States

**Facility:** Peninsula Cardiology

**State:** Maryland

**Zip:** 21804

**Location 60:**

**City:** Ayer

**Country:** United States

**Facility:** Primary Care Specialists Inc

**State:** Massachusetts

**Zip:** 01432

**Location 61:**

**City:** Chelmsford

**Country:** United States

**Facility:** Merrimack Valley Cardiology

**State:** Massachusetts

**Zip:** 01824

**Location 62:**

**City:** Weymouth

**Country:** United States

**Facility:** Harbor Medical AssociatesSo Weymouth

**State:** Massachusetts

**Zip:** 02190

**Location 63:**

**City:** Farmington Hills

**Country:** United States

**Facility:** Consultants in Cardiology

**State:** Michigan

**Zip:** 48331

**Location 64:**

**City:** Rochester

**Country:** United States

**Facility:** Cardiovascular Consultants PC

**State:** Michigan

**Zip:** 48312

**Location 65:**

**City:** Roseville

**Country:** United States

**Facility:** Eastside Cardiology, Roseville

**State:** Michigan

**Zip:** 48066

**Location 66:**

**City:** Saint Paul

**Country:** United States

**Facility:** St. Paul Cardiology

**State:** Minnesota

**Zip:** 55102

**Location 67:**

**City:** Jackson

**Country:** United States

**Facility:** University of Mississippi Medical Center

**State:** Mississippi

**Zip:** 39216

**Location 68:**

**City:** Columbia

**Country:** United States

**Facility:** Missouri Cardiovascular Specialists

**State:** Missouri

**Zip:** 65201

**Location 69:**

**City:** Columbia

**Country:** United States

**Facility:** University Hospital Healthcare

**State:** Missouri

**Zip:** 65210

**Location 70:**

**City:** Joplin

**Country:** United States

**Facility:** Freeman Heart Institute

**State:** Missouri

**Zip:** 64804

**Location 71:**

**City:** Saint Louis

**Country:** United States

**Facility:** Mercy Cardiology

**State:** Missouri

**Zip:** 63101

**Location 72:**

**City:** Saint Louis

**Country:** United States

**Facility:** Cardiology Diagnostics, Ltd,

**State:** Missouri

**Zip:** 63131

**Location 73:**

**City:** Concord

**Country:** United States

**Facility:** Cardiac Associates of New Hampshire

**State:** New Hampshire

**Zip:** 03303

**Location 74:**

**City:** Lebanon

**Country:** United States

**Facility:** Dartmouth-Hitchcock Medical Center

**State:** New Hampshire

**Zip:** 03756

**Location 75:**

**City:** Lebanon

**Country:** United States

**Facility:** Dartmouth-Hitchcock Medical Center

**State:** New Hampshire

**Zip:** 03766

**Location 76:**

**City:** Bridgewater

**Country:** United States

**Facility:** Medicor

**State:** New Jersey

**Zip:** 08807

**Location 77:**

**City:** Edgewater

**Country:** United States

**Facility:** Cross County Cardiology

**State:** New Jersey

**Zip:** 07020

**Location 78:**

**City:** Hawthorne

**Country:** United States

**Facility:** Heart-Lung Center

**State:** New Jersey

**Zip:** 07506-1919

**Location 79:**

**City:** Voorhees

**Country:** United States

**Facility:** Southern New Jersey Cardiac Specialists

**State:** New Jersey

**Zip:** 08043

**Location 80:**

**City:** West Orange

**Country:** United States

**Facility:** Diagnostic and Clinical Cardiologists

**State:** New Jersey

**Zip:** 07052

**Location 81:**

**City:** Westwood

**Country:** United States

**Facility:** Westwood Cardiology

**State:** New Jersey

**Zip:** 07675

**Location 82:**

**City:** Albany

**Country:** United States

**Facility:** Albany Associates in Cardiology,

**State:** New York

**Zip:** 12205

**Location 83:**

**City:** Brooklyn

**Country:** United States

**Facility:** SUNY Downstate Medical Center

**State:** New York

**Zip:** 11203

**Location 84:**

**City:** Brooklyn

**Country:** United States

**Facility:** Cardiology Associates of Brooklyn

**State:** New York

**Zip:** 11219

**Location 85:**

**City:** Brooklyn

**Country:** United States

**Facility:** United Medical Associates

**State:** New York

**Zip:** 11219

**Location 86:**

**City:** Manhattan

**Country:** United States

**Facility:** Concorde Medical Group/NYU Hospital

**State:** New York

**Zip:** 10001

**Location 87:**

**City:** Mineola

**Country:** United States

**Facility:** Island Cardiac Specialists

**State:** New York

**Zip:** 11501

**Location 88:**

**City:** Mineola

**Country:** United States

**Facility:** Island Cardiac Specialist

**State:** New York

**Zip:** 11501

**Location 89:**

**City:** New York

**Country:** United States

**Facility:** Gotham Cardiovascular Research

**State:** New York

**Zip:** 10001

**Location 90:**

**City:** Scarsdale

**Country:** United States

**Facility:** Westchester Medical Group

**State:** New York

**Zip:** 10583

**Location 91:**

**City:** Staten Island

**Country:** United States

**Facility:** Vazzana and Bogin Cardiology Associates

**State:** New York

**Zip:** 10305

**Location 92:**

**City:** Syracuse

**Country:** United States

**Facility:** Cardiology PC

**State:** New York

**Zip:** 13210

**Location 93:**

**City:** West Islip

**Country:** United States

**Facility:** Southbay Cardiology

**State:** New York

**Zip:** 11795

**Location 94:**

**City:** Asheville

**Country:** United States

**Facility:** Asheville Cardiology Associates

**State:** North Carolina

**Zip:** 28803

**Location 95:**

**City:** Charlotte

**Country:** United States

**Facility:** Sanger Clinic

**State:** North Carolina

**Zip:** 28202

**Location 96:**

**City:** Gastonia

**Country:** United States

**Facility:** Carolina Heart Specialists

**State:** North Carolina

**Zip:** 28054

**Location 97:**

**City:** Greensboro

**Country:** United States

**Facility:** Southeastern Heart and Vascular

**State:** North Carolina

**Zip:** 27403

**Location 98:**

**City:** Hickory

**Country:** United States

**Facility:** Hickory Cardiology

**State:** North Carolina

**Zip:** 28602

**Location 99:**

**City:** High Point

**Country:** United States

**Facility:** Carolina Cardiology Associates

**State:** North Carolina

**Zip:** 27262

**Location 100:**

**City:** New Bern

**Country:** United States

**Facility:** Heart Center of Eastern Carolina,

**State:** North Carolina

**Zip:** 28562

**Location 101:**

**City:** New Bern

**Country:** United States

**Facility:** Heart Center of Eastern Carolina

**State:** North Carolina

**Zip:** 28562

**Location 102:**

**City:** Pinehurst

**Country:** United States

**Facility:** Pinehurst Cardiology Consultants

**State:** North Carolina

**Zip:** 28370

**Location 103:**

**City:** Pinehurst

**Country:** United States

**Facility:** Pinehurst Cardiology Consultants

**State:** North Carolina

**Zip:** 28374

**Location 104:**

**City:** Raleigh

**Country:** United States

**Facility:** Raleigh Cardiology

**State:** North Carolina

**Zip:** 27610

**Location 105:**

**City:** Fargo

**Country:** United States

**Facility:** Meritcare Medical Center

**State:** North Dakota

**Zip:** 58122

**Location 106:**

**City:** Akron

**Country:** United States

**Facility:** Northeast Ohio Cardiovascular Specialists

**State:** Ohio

**Zip:** 44301

**Location 107:**

**City:** Cleveland

**Country:** United States

**Facility:** Muhammed H. Zahra

**State:** Ohio

**Zip:** 44125

**Location 108:**

**City:** Cleveland

**Country:** United States

**Facility:** Cleveland Clinic Foundation

**State:** Ohio

**Zip:** 44195

**Location 109:**

**City:** Columbus

**Country:** United States

**Facility:** Doctors Hospital Heart Failure Clinic

**State:** Ohio

**Zip:** 43228

**Location 110:**

**City:** Kettering

**Country:** United States

**Facility:** Schuster Cardiology Associates

**State:** Ohio

**Zip:** 45336

**Location 111:**

**City:** Lima

**Country:** United States

**Facility:** The Heart Institute of Northwest Ohio

**State:** Ohio

**Zip:** 45801

**Location 112:**

**City:** Newark

**Country:** United States

**Facility:** Bryce Morrice MD and Debra Heldman MD Inc

**State:** Ohio

**Zip:** 43055

**Location 113:**

**City:** Parma

**Country:** United States

**Facility:** Cardiovascular Clinic, Inc.

**State:** Ohio

**Zip:** 44129

**Location 114:**

**City:** Toledo

**Country:** United States

**Facility:** North West Ohio Cardiology Consultants

**State:** Ohio

**Zip:** 43615

**Location 115:**

**City:** Abington

**Country:** United States

**Facility:** Abington Medical Specialists

**State:** Pennsylvania

**Zip:** 19001

**Location 116:**

**City:** Danville

**Country:** United States

**Facility:** Geisinger Medical Center

**State:** Pennsylvania

**Zip:** 17822

**Location 117:**

**City:** Doylestown

**Country:** United States

**Facility:** Central Bucks Specialists, Ltd.,

**State:** Pennsylvania

**Zip:** 18901

**Location 118:**

**City:** Harrisburg

**Country:** United States

**Facility:** Associated Cardiologists

**State:** Pennsylvania

**Zip:** 17103

**Location 119:**

**City:** Lancaster

**Country:** United States

**Facility:** The Heart Group, Ltd

**State:** Pennsylvania

**Zip:** 17603

**Location 120:**

**City:** Philadelphia

**Country:** United States

**Facility:** Drexel University College of Medicine

**State:** Pennsylvania

**Zip:** 19129

**Location 121:**

**City:** Wynnewood

**Country:** United States

**Facility:** Cardiology Associates of Southeastern PA

**State:** Pennsylvania

**Zip:** 19064

**Location 122:**

**City:** York

**Country:** United States

**Facility:** York Hospital

**State:** Pennsylvania

**Zip:** 17403

**Location 123:**

**City:** Pawtucket

**Country:** United States

**Facility:** Blackstone Cardiology Associates

**State:** Rhode Island

**Zip:** 02860

**Location 124:**

**City:** Charleston

**Country:** United States

**Facility:** Medical University of South

**State:** South Carolina

**Zip:** 29406

**Location 125:**

**City:** Greenville

**Country:** United States

**Facility:** Upstate Cardiology

**State:** South Carolina

**Zip:** 29605

**Location 126:**

**City:** Myrtle Beach

**Country:** United States

**Facility:** Cardiology Associates

**State:** South Carolina

**Zip:** 29572

**Location 127:**

**City:** Spartanburg

**Country:** United States

**Facility:** Cardiology Consultants, PA

**State:** South Carolina

**Zip:** 29301

**Location 128:**

**City:** Sumter

**Country:** United States

**Facility:** Sumter Medical Consultants

**State:** South Carolina

**Zip:** 29150

**Location 129:**

**City:** West Columbia

**Country:** United States

**Facility:** Columbia Cardiology Consultants

**State:** South Carolina

**Zip:** 29204

**Location 130:**

**City:** Germantown

**Country:** United States

**Facility:** Sutherland Clinic

**State:** Tennessee

**Zip:** 38119

**Location 131:**

**City:** Lexington

**Country:** United States

**Facility:** Dela Clinic

**State:** Tennessee

**Zip:** 38351

**Location 132:**

**City:** Arlington

**Country:** United States

**Facility:** Heart Place North Arlington

**State:** Texas

**Zip:** 75284

**Location 133:**

**City:** Dallas

**Country:** United States

**Facility:** University of Texas South Western Medical Center at Dallas

**State:** Texas

**Zip:** 75201

**Location 134:**

**City:** Houston

**Country:** United States

**Facility:** Comprehensive Heart Care, PA

**State:** Texas

**Zip:** 77024

**Location 135:**

**City:** Houston

**Country:** United States

**Facility:** Cardiology Consultants of Houston

**State:** Texas

**Zip:** 77030

**Location 136:**

**City:** Plano

**Country:** United States

**Facility:** Legacy Heart Center

**State:** Texas

**Zip:** 75024

**Location 137:**

**City:** San Antonio

**Country:** United States

**Facility:** Cardiology Clinic of San Antonio

**State:** Texas

**Zip:** 78229

**Location 138:**

**City:** San Antonio

**Country:** United States

**Facility:** Wilford Hall Medical Center

**State:** Texas

**Zip:** 78229

**Location 139:**

**City:** Tyler

**Country:** United States

**Facility:** Tyler Cardiovascular Consultants

**State:** Texas

**Zip:** 75701

**Location 140:**

**City:** Burlington

**Country:** United States

**Facility:** University Associates in Cardiology

**State:** Vermont

**Zip:** 05401

**Location 141:**

**City:** Fairfax

**Country:** United States

**Facility:** Cardiology Associates of Lakeview

**State:** Virginia

**Zip:** 05454

**Location 142:**

**City:** Fairfax

**Country:** United States

**Facility:** The Cardiovascular Group

**State:** Virginia

**Zip:** 22031

**Location 143:**

**City:** Hampton

**Country:** United States

**Facility:** Tidewater Heart Specialists, Inc.,

**State:** Virginia

**Zip:** 23666

**Location 144:**

**City:** Green Bay

**Country:** United States

**Facility:** Cardiology Associates of Green Bay

**State:** Wisconsin

**Zip:** 54301

#### Overall Officials

**Official 1:**

**Affiliation:** University of California at Los Angeles

**Name:** Gregg Fonarow, MD

**Role:** STUDY_CHAIR

**Official 2:**

**Affiliation:** UT Southwestern Medical Center at Dallas

**Name:** Clyde Yancy, MD

**Role:** STUDY_CHAIR

### References Module

#### References

**Citation:** Shukla A, Curtis AB, Mehra MR, Albert NM, Gheorghiade M, Heywood JT, Liu Y, O'Connor CM, Reynolds D, Walsh MN, Yancy CW, Fonarow GC. Factors associated with improvement in utilization of cardiac resynchronization therapy in eligible heart failure patients: findings from IMPROVE HF. Pacing Clin Electrophysiol. 2013 Apr;36(4):433-43. doi: 10.1111/pace.12090. Epub 2013 Feb 4.

**PMID:** 23380000

**Citation:** Barkoudah E, Skali H, Uno H, Solomon SD, Pfeffer MA. Mortality rates in trials of subjects with type 2 diabetes. J Am Heart Assoc. 2012 Feb;1(1):8-15. doi: 10.1161/JAHA.111.000059. Epub 2012 Feb 20.

**PMID:** 23130114

**Citation:** Reynolds D, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Mcbride ML, Inge PJ, Mehra MR, O'Connor CM, Walsh MN, Yancy CW, Fonarow GC. Race and improvements in the use of guideline-recommended therapies for patients with heart failure: findings from IMPROVE HF. J Natl Med Assoc. 2012 May-Jun;104(5-6):287-98. doi: 10.1016/s0027-9684(15)30156-5.

**PMID:** 22973678

**Citation:** Fonarow GC, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Liu Y, Mehra MR, O'Connor CM, Reynolds D, Walsh MN, Yancy CW. Associations between outpatient heart failure process-of-care measures and mortality. Circulation. 2011 Apr 19;123(15):1601-10. doi: 10.1161/CIRCULATIONAHA.110.989632. Epub 2011 Apr 4.

**PMID:** 21464053

**Citation:** Walsh MN, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Heywood JT, Inge PJ, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Fonarow GC. Equitable improvement for women and men in the use of guideline-recommended therapies for heart failure: findings from IMPROVE HF. J Card Fail. 2010 Dec;16(12):940-9. doi: 10.1016/j.cardfail.2010.07.250.

**PMID:** 21111983

**Citation:** Fonarow GC, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Inge PJ, Mehra MR, O'Connor CM, Reynolds D, Walsh MN, Yancy CW. Improving evidence-based care for heart failure in outpatient cardiology practices: primary results of the Registry to Improve the Use of Evidence-Based Heart Failure Therapies in the Outpatient Setting (IMPROVE HF). Circulation. 2010 Aug 10;122(6):585-96. doi: 10.1161/CIRCULATIONAHA.109.934471. Epub 2010 Jul 26.

**PMID:** 20660805

**Citation:** Heywood JT, Fonarow GC, Yancy CW, Albert NM, Curtis AB, Gheorghiade M, Inge PJ, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Walsh MN. Comparison of medical therapy dosing in outpatients cared for in cardiology practices with heart failure and reduced ejection fraction with and without device therapy: report from IMPROVE HF. Circ Heart Fail. 2010 Sep;3(5):596-605. doi: 10.1161/CIRCHEARTFAILURE.109.912683. Epub 2010 Jul 15.

**PMID:** 20634483

**Citation:** Walsh MN, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, O'Connor CM, Reynolds D, Fonarow GC. Electronic health records and quality of care for heart failure. Am Heart J. 2010 Apr;159(4):635-642.e1. doi: 10.1016/j.ahj.2010.01.006.

**PMID:** 20362723

**Citation:** Mehra MR, Yancy CW, Albert NM, Curtis AB, Stough WG, Gheorghiade M, Heywood JT, McBride ML, O'Connor CM, Reynolds D, Walsh MN, Fonarow GC. Evidence of clinical practice heterogeneity in the use of implantable cardioverter-defibrillators in heart failure and post-myocardial infarction left ventricular dysfunction: Findings from IMPROVE HF. Heart Rhythm. 2009 Dec;6(12):1727-34. doi: 10.1016/j.hrthm.2009.08.022. Epub 2009 Aug 22.

**PMID:** 19959119

**Citation:** Curtis AB, Yancy CW, Albert NM, Stough WG, Gheorghiade M, Heywood JT, McBride ML, Mehra MR, Oconnor CM, Reynolds D, Walsh MN, Fonarow GC. Cardiac resynchronization therapy utilization for heart failure: findings from IMPROVE HF. Am Heart J. 2009 Dec;158(6):956-64. doi: 10.1016/j.ahj.2009.10.011.

**PMID:** 19958862

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000006331

- Term: Heart Diseases

- ID: D000002318

- Term: Cardiovascular Diseases

- ID: D000007511

- Term: Ischemia

- ID: D000010335

- Term: Pathologic Processes

- ID: D000009336

- Term: Necrosis

- ID: D000017202

- Term: Myocardial Ischemia

- ID: D000014652

- Term: Vascular Diseases

### Condition Browse Module - Browse Branches

- Abbrev: BC14

- Name: Heart and Blood Diseases

- Abbrev: All

- Name: All Conditions

- Abbrev: BC23

- Name: Symptoms and General Pathology

### Condition Browse Module - Browse Leaves

- ID: M9421

- Name: Heart Failure

- Relevance: HIGH

- As Found: Heart Failure

- ID: M20591

- Name: Ventricular Dysfunction, Left

- Relevance: HIGH

- As Found: Ventricular Dysfunction, Left

- ID: M27583

- Name: Systolic Murmurs

- Relevance: LOW

- As Found: Unknown

- ID: M12155

- Name: Myocardial Infarction

- Relevance: HIGH

- As Found: Myocardial Infarction

- ID: M10282

- Name: Infarction

- Relevance: HIGH

- As Found: Infarction

- ID: M20824

- Name: Ventricular Dysfunction

- Relevance: HIGH

- As Found: Ventricular Dysfunction

- ID: M27579

- Name: Heart Failure, Systolic

- Relevance: LOW

- As Found: Unknown

- ID: M9419

- Name: Heart Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M10543

- Name: Ischemia

- Relevance: LOW

- As Found: Unknown

- ID: M12284

- Name: Necrosis

- Relevance: LOW

- As Found: Unknown

- ID: M6546

- Name: Coronary Artery Disease

- Relevance: LOW

- As Found: Unknown

- ID: M19506

- Name: Myocardial Ischemia

- Relevance: LOW

- As Found: Unknown

- ID: M17400

- Name: Vascular Diseases

- Relevance: LOW

- As Found: Unknown

### Condition Browse Module - Meshes

- ID: D000006333

- Term: Heart Failure

- ID: D000009203

- Term: Myocardial Infarction

- ID: D000018754

- Term: Ventricular Dysfunction

- ID: D000018487

- Term: Ventricular Dysfunction, Left

- ID: D000007238

- Term: Infarction

### Misc Info Module

- Version Holder: 2024-05-24

## Results Section

### Adverse Events Module

**Description:** Adverse events were not collected for this study.

#### Event Groups

**Group ID:** EG000

**Title:** Cohort A (Baseline, 12 and 24 Months)

**Description:** Cohort A: The charts of 15,177 patients were reviewed at baseline, 12 months and 24 months. The principal investigator and HF nurse of the study sites attended an educational workshop at baseline, 12 and 24 months as well where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort A is a longitudinal cohort.

**ID:** EG000

**Title:** Cohort A (Baseline, 12 and 24 Months)

**Group ID:** EG001

**Title:** Cohort B (6 Months)

**Description:** Cohort B: The charts of 9,992 patients were reviewed at 6 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort B is a single time point cohort.

**ID:** EG001

**Title:** Cohort B (6 Months)

**Group ID:** EG002

**Title:** Cohort C (18 Months)

**Description:** Cohort C: The charts of 9,641 patients were reviewed at 18 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort C is a single time point cohort.

**ID:** EG002

**Title:** Cohort C (18 Months)

**Frequency Threshold:** 0

## Results Section - Baseline Characteristics Module

### Denomination Counts

**Group ID:** BG000

**Value:** 15177

**Group ID:** BG001

**Value:** 9992

**Group ID:** BG002

**Value:** 9641

**Group ID:** BG003

**Value:** 34810

**Units:** Participants

### Group

**ID:** BG000

**Title:** Cohort A (Baseline, 12 and 24 Months)

**Description:** Cohort A: The charts of 15,177 patients were reviewed at baseline, 12 months and 24 months. The principal investigator and HF nurse of the study sites attended an educational workshop at baseline, 12 and 24 months as well where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort A is a longitudinal cohort.

### Group

**ID:** BG001

**Title:** Cohort B (6 Months)

**Description:** Cohort B: The charts of 9,992 patients were reviewed at 6 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort B is a single time point cohort.

### Group

**ID:** BG002

**Title:** Cohort C (18 Months)

**Description:** Cohort C: The charts of 9,641 patients were reviewed at 18 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort C is a single time point cohort.

### Group

**ID:** BG003

**Title:** Total

**Description:** Total of all reporting groups

### Measure

#### Measurement

**Group ID:** BG000

**Spread:** 13.2

**Value:** 68.7

#### Measurement

**Group ID:** BG001

**Spread:** 13.2

**Value:** 68.3

#### Measurement

**Group ID:** BG002

**Spread:** 13.6

**Value:** 68.2

#### Measurement

**Group ID:** BG003

**Spread:** 13.3

**Value:** 68.4

**Class Title:** 

### Measure

#### Measurement

**Group ID:** BG000

**Value:** 5274

#### Measurement

**Group ID:** BG001

**Value:** 3606

#### Measurement

**Group ID:** BG002

**Value:** 3539

#### Measurement

**Group ID:** BG003

**Value:** 12419

**Class Title:** <=64 years

#### Measurement

**Group ID:** BG000

**Value:** 5127

#### Measurement

**Group ID:** BG001

**Value:** 3344

#### Measurement

**Group ID:** BG002

**Value:** 3089

#### Measurement

**Group ID:** BG003

**Value:** 11560

**Class Title:** Between 64 and 76 years

#### Measurement

**Group ID:** BG000

**Value:** 4748

#### Measurement

**Group ID:** BG001

**Value:** 3041

#### Measurement

**Group ID:** BG002

**Value:** 3010

#### Measurement

**Group ID:** BG003

**Value:** 10799

**Class Title:** >76 years

#### Measurement

**Group ID:** BG000

**Value:** 28

#### Measurement

**Group ID:** BG001

**Value:** 1

#### Measurement

**Group ID:** BG002

**Value:** 3

#### Measurement

**Group ID:** BG003

**Value:** 32

**Class Title:** Missing

### Measure

#### Measurement

**Group ID:** BG000

**Value:** 4383

#### Measurement

**Group ID:** BG001

**Value:** 2918

#### Measurement

**Group ID:** BG002

**Value:** 2827

#### Measurement

**Group ID:** BG003

**Value:** 10128

**Class Title:** Female

#### Measurement

**Group ID:** BG000

**Value:** 10787

#### Measurement

**Group ID:** BG001

**Value:** 7069

#### Measurement

**Group ID:** BG002

**Value:** 6814

#### Measurement

**Group ID:** BG003

**Value:** 24670

**Class Title:** Male

#### Measurement

**Group ID:** BG000

**Value:** 7

#### Measurement

**Group ID:** BG001

**Value:** 5

#### Measurement

**Group ID:** BG002

**Value:** 0

#### Measurement

**Group ID:** BG003

**Value:** 12

**Class Title:** Missing

### Measure

#### Measurement

**Group ID:** BG000

**Value:** 15177

#### Measurement

**Group ID:** BG001

**Value:** 9992

#### Measurement

**Group ID:** BG002

**Value:** 9641

#### Measurement

**Group ID:** BG003

**Value:** 34810

**Class Title:** United States

**Denomination Units Selected:** 

## Results Section - Baseline Characteristics Module

### Measure 1
**Dispersion Type:** STANDARD_DEVIATION
**Parameter Type:** MEAN
**Title:** Age, Continuous
**Unit of Measure:** years
### Measure 2
**Parameter Type:** NUMBER
**Title:** Age, Customized
**Unit of Measure:** participants
### Measure 3
**Parameter Type:** NUMBER
**Title:** Sex/Gender, Customized
**Unit of Measure:** participants
### Measure 4
**Parameter Type:** NUMBER
**Title:** Region of Enrollment
**Unit of Measure:** participants
## Results Section - More Information Module
### Certain Agreement
**Other Details:** In most cases, contracts allow investigators ("PI") to publish per the publication strategy/Clinical Investigation Plan following Medtronic's review for (a) disclosure of confidential information ("CI"), and (b) selection and order of publications by the publications committee. Any such CI is deleted prior to publication/presentation. Medtronic may not otherwise censor/interfere with the publication. PI's may not publish single-site data until the main multi-site publication has occurred.
**Restriction Type:** OTHER
**Restrictive Agreement:** True
### Point of Contact
**Email:** medtronicCRMtrials@medtronic.com
**Organization:** Medtronic Cardiac Rhythm Disease Management
**Title:** IMPROVE HF, Clinical Research Specialist
## Results Section - Outcome Measures Module
### Outcome Measure 1
#### Analysis
**CI Lower Limit:** 7.0
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 9.7
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #1: relative change in % of eligible patients treated with angiotensin converting enzyme inhibitor and/or angiotensin II receptor blockers (ACEU/ARB).
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative Improvement (%)
**Parameter Value:** 8.4
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 7.7
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 9.6
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #2: relative change in % of eligible patients treated with beta-blockers.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative improvement (%)
**Parameter Value:** 8.6
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 70.5
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 89.0
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #3: relative change in % of eligible patients treated with aldosterone receptor antagonists.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative improvement (%)
**Parameter Value:** 79.7
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -2.2
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 4.2
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #4: relative change in % of eligible patients treated with anticoagulation for AF.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.546
**P-Value Comment:** 
**Parameter Type:** Relative Improvement (%)
**Parameter Value:** 1.0
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 72.2
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 91.7
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #5: relative change in % of eligible patients treated with cardiac resynchronization therapy (CRT-P/CRT-D).
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative Improvement (%)
**Parameter Value:** 81.9
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 59.1
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 65.1
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #6: relative change in % of eligible patients treated with implantable cardioverter-defibrillator (ICD) or CRT-D.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative Improvement (%)
**Parameter Value:** 62.1
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 12.6
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 16.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #7: relative change in % of eligible patients with HF education.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Relative Improvement (%)
**Parameter Value:** 14.7
**Statistical Comment:** 
**Statistical Method:** a large sample test (z-test)
**Tested Non-Inferiority:** 
### Outcome Measure 2
### Outcome Measure 3
#### Analysis
**CI Lower Limit:** -1.1
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 39.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #1: Relative change at 24 months compared with baseline in ACEI/ARB for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.004
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 19.4
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 5.1
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 10.2
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #2: the relative change at 24 months compared with baseline in beta-blockers for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 7.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 24.6
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 35.5
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #3: the relative change at 24 months compared with baseline in aldosterone antagonist for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 30.0
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -3.6
**CI Number of Sides:** 
**CI Percentage Value:** 95
**CI Upper Limit:** 5.5
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #4: the relative change at 24 months compared with baseline in anticoagulation for AF for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.513
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 1.0
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 37.9
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 58.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #5: the relative change at 24 months compared with baseline in CRT-P/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 48.4
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 61.0
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 80.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #6: the relative change at 24 months compared with baseline in ICD/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 70.9
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 27.1
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 74.2
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #7: the relative change at 24 months compared with baseline in HF education for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 50.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 16.3
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 22.0
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Composite Score: The relative change at 24 months compared with baseline in composite score for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 19.2
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
### Outcome Measure 4
#### Analysis
**CI Lower Limit:** -5.4
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 25.9
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #1: the relative change of Cohort B (6 months) compared with Cohort A at baseline in ACEI/ARB for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.197
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 10.3
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -0.5
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 21.7
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #2: the relative change of Cohort B (6 months) compared with Cohort A at baseline in beta-blockers for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.061
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 10.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -5.7
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 3.4
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #3: the relative change of Cohort B (6 months) compared with Cohort A at baseline in aldosterone antagonist for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.622
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** -1.1
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 0.0
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 12.4
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #4: the relative change of Cohort B (6 months) compared with Cohort A at baseline in anticoagulation for AF for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.05
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 6.2
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -11.2
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 7.7
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #5: the relative change of Cohort B (6 months) compared with Cohort A at baseline in CRT-P/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.711
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** -1.8
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 6.9
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 22.0
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #6: the relative change of Cohort B (6 months) compared with Cohort A at baseline in ICD/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 14.4
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 23.2
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 53.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #7: the relative change of Cohort B (6 months) compared with Cohort A at baseline in HF education for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 38.5
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 4.2
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 9.0
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Composite Score: the relative change of Cohort B (6 months) compared with Cohort A at baseline in composite score for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 6.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
### Outcome Measure 5
#### Analysis
**CI Lower Limit:** -5.3
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 26.3
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #1: the relative change of Cohort C (18 months) compared with Cohort A at baseline in ACEI/ARB for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.190
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 10.5
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 0.1
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 28.4
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #2: the relative change of Cohort C (18 months) compared with Cohort A at baseline in beta-blockers for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.048
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 14.3
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -3.9
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 15.4
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #3: the relative change of Cohort C (18 months) compared with Cohort A at baseline in aldosterone antagonist for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.240
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 5.8
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 0.5
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 13.0
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #4: the relative change of Cohort C (18 months) compared with Cohort A at baseline in anticoagulation for AF for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.033
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 6.7
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** -1.3
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 19.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #5: the relative change of Cohort C (18 months) compared with Cohort A at baseline in CRT-P/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** 0.085
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 9.3
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 9.3
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 25.8
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #6: the relative change of Cohort C (18 months) compared with Cohort A at baseline in ICD/CRT-D for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 17.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 33.9
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 85.2
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Performance Measure #7: the relative change of Cohort C (18 months) compared with Cohort A at baseline in HF education for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 59.5
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
#### Analysis
**CI Lower Limit:** 7.6
**CI Number of Sides:** TWO_SIDED
**CI Percentage Value:** 95
**CI Upper Limit:** 13.6
**CI Upper Limit Comment:** 
**Dispersion Type:** 
**Dispersion Value:** 
**Estimate Comment:** 
**Group Description:** Composite Score: the relative change of Cohort C (18 months) compared with Cohort A at baseline in composite score for the aggregate practices.
**Non-Inferiority Comment:** 
**Non-Inferiority Type:** SUPERIORITY_OR_OTHER
**Other Analysis Description:** 
**P-Value:** <0.001
**P-Value Comment:** 
**Parameter Type:** Mean Relative Change (%)
**Parameter Value:** 10.6
**Statistical Comment:** 
**Statistical Method:** t-test, 2 sided
**Tested Non-Inferiority:** 
## Results Section
### Outcome Measures Module
#### Outcome Measure 1
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 79.2
- **Spread:** 
- **Upper Limit:** 80.5
- **Value:** 79.8
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 85.6
- **Spread:** 
- **Upper Limit:** 87.3
- **Value:** 86.5
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 7.0
- **Spread:** 
- **Upper Limit:** 9.7
- **Value:** 8.4
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 85.6
- **Spread:** 
- **Upper Limit:** 86.8
- **Value:** 86.2
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 93.0
- **Spread:** 
- **Upper Limit:** 94.2
- **Value:** 93.6
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 7.7
- **Spread:** 
- **Upper Limit:** 9.6
- **Value:** 8.6
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 32.7
- **Spread:** 
- **Upper Limit:** 36.1
- **Value:** 34.4
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 59.2
- **Spread:** 
- **Upper Limit:** 64.5
- **Value:** 61.8
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 70.5
- **Spread:** 
- **Upper Limit:** 89.0
- **Value:** 79.7
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 67.2
- **Spread:** 
- **Upper Limit:** 70.0
- **Value:** 68.6
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 67.5
- **Spread:** 
- **Upper Limit:** 71.0
- **Value:** 69.3
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** -2.2
- **Spread:** 
- **Upper Limit:** 4.2
- **Value:** 1.0
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 35.2
- **Spread:** 
- **Upper Limit:** 40.1
- **Value:** 37.7
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 65.8
- **Spread:** 
- **Upper Limit:** 71.3
- **Value:** 68.5
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 72.2
- **Spread:** 
- **Upper Limit:** 91.7
- **Value:** 81.9
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 47.8
- **Spread:** 
- **Upper Limit:** 49.8
- **Value:** 48.8
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 78.0
- **Spread:** 
- **Upper Limit:** 80.2
- **Value:** 79.1
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 59.1
- **Spread:** 
- **Upper Limit:** 65.1
- **Value:** 62.1
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 61.0
- **Spread:** 
- **Upper Limit:** 62.5
- **Value:** 61.8
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 69.8
- **Spread:** 
- **Upper Limit:** 71.9
- **Value:** 70.8
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 12.6
- **Spread:** 
- **Upper Limit:** 16.8
- **Value:** 14.7
**Title:** 
#### Outcome Measure 2
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 15
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 9
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 82
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 14
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 83
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 114
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 59
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 
- **Upper Limit:** 
- **Value:** 123
**Title:** 
#### Outcome Measure 3
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 11.5
- **Upper Limit:** 
- **Value:** 78.3
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 10.6
- **Upper Limit:** 
- **Value:** 85.1
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 128.9
- **Upper Limit:** 
- **Value:** 19.4
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 10.8
- **Upper Limit:** 
- **Value:** 86.0
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 9.8
- **Upper Limit:** 
- **Value:** 92.2
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 16.1
- **Upper Limit:** 
- **Value:** 7.6
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 18.5
- **Upper Limit:** 
- **Value:** 34.5
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 25.9
- **Upper Limit:** 
- **Value:** 60.3
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 33.8
- **Upper Limit:** 
- **Value:** 30.0
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 16.1
- **Upper Limit:** 
- **Value:** 68.0
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 18.0
- **Upper Limit:** 
- **Value:** 67.8
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 28.5
- **Upper Limit:** 
- **Value:** 1.0
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 30.5
- **Upper Limit:** 
- **Value:** 37.2
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 29.0
- **Upper Limit:** 
- **Value:** 66.3
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 62.3
- **Upper Limit:** 
- **Value:** 48.4
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 17.5
- **Upper Limit:** 
- **Value:** 50.1
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 16.8
- **Upper Limit:** 
- **Value:** 77.5
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 62.4
- **Upper Limit:** 
- **Value:** 70.9
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 23.7
- **Upper Limit:** 
- **Value:** 59.5
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 24.0
- **Upper Limit:** 
- **Value:** 72.1
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 147.7
- **Upper Limit:** 
- **Value:** 50.6
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 8.9
- **Upper Limit:** 
- **Value:** 67.1
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 9.3
- **Upper Limit:** 
- **Value:** 79.0
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 18.1
- **Upper Limit:** 
- **Value:** 19.2
**Title:** 
#### Outcome Measure 4
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 11.3
- **Upper Limit:** 
- **Value:** 78.7
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 10.6
- **Upper Limit:** 
- **Value:** 80.2
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 97.1
- **Upper Limit:** 
- **Value:** 10.3
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 10.9
- **Upper Limit:** 
- **Value:** 85.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 7.2
- **Upper Limit:** 
- **Value:** 90.0
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 68.9
- **Upper Limit:** 
- **Value:** 10.6
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 18.7
- **Upper Limit:** 
- **Value:** 34.7
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 20.7
- **Upper Limit:** 
- **Value:** 33.4
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 27.4
- **Upper Limit:** 
- **Value:** -1.1
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 15.8
- **Upper Limit:** 
- **Value:** 67.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 17.4
- **Upper Limit:** 
- **Value:** 68.9
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 38.2
- **Upper Limit:** 
- **Value:** 6.2
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 30.7
- **Upper Limit:** 
- **Value:** 37.6
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 27.8
- **Upper Limit:** 
- **Value:** 34.9
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 53.7
- **Upper Limit:** 
- **Value:** -1.8
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 17.0
- **Upper Limit:** 
- **Value:** 49.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 17.4
- **Upper Limit:** 
- **Value:** 52.7
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 46.9
- **Upper Limit:** 
- **Value:** 14.4
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 23.6
- **Upper Limit:** 
- **Value:** 59.4
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 20.8
- **Upper Limit:** 
- **Value:** 67.5
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 94.8
- **Upper Limit:** 
- **Value:** 38.5
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 8.8
- **Upper Limit:** 
- **Value:** 67.1
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 8.0
- **Upper Limit:** 
- **Value:** 70.7
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 15.1
- **Upper Limit:** 
- **Value:** 6.6
**Title:** 
#### Outcome Measure 5
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 11.3
- **Upper Limit:** 
- **Value:** 78.7
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 12.2
- **Upper Limit:** 
- **Value:** 80.3
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 97.9
- **Upper Limit:** 
- **Value:** 10.5
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 10.9
- **Upper Limit:** 
- **Value:** 85.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 7.0
- **Upper Limit:** 
- **Value:** 91.8
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 87.7
- **Upper Limit:** 
- **Value:** 14.3
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 18.7
- **Upper Limit:** 
- **Value:** 34.7
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 23.1
- **Upper Limit:** 
- **Value:** 36.6
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 58.3
- **Upper Limit:** 
- **Value:** 5.8
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 15.8
- **Upper Limit:** 
- **Value:** 67.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 17.1
- **Upper Limit:** 
- **Value:** 69.6
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 38.3
- **Upper Limit:** 
- **Value:** 6.7
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 30.7
- **Upper Limit:** 
- **Value:** 37.6
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 30.1
- **Upper Limit:** 
- **Value:** 43.5
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 59.7
- **Upper Limit:** 
- **Value:** 9.3
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 17.0
- **Upper Limit:** 
- **Value:** 49.9
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 17.2
- **Upper Limit:** 
- **Value:** 54.0
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 51.3
- **Upper Limit:** 
- **Value:** 17.6
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 23.6
- **Upper Limit:** 
- **Value:** 59.4
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 22.6
- **Upper Limit:** 
- **Value:** 75.0
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 158.5
- **Upper Limit:** 
- **Value:** 59.5
**Title:** 
**Class:**
##### Category
**Measurements:**
- **Comment:** 
- **Group ID:** OG000
- **Lower Limit:** 
- **Spread:** 8.8
- **Upper Limit:** 
- **Value:** 67.1
- **Comment:** 
- **Group ID:** OG001
- **Lower Limit:** 
- **Spread:** 8.4
- **Upper Limit:** 
- **Value:** 73.2
- **Comment:** 
- **Group ID:** OG002
- **Lower Limit:** 
- **Spread:** 18.5
- **Upper Limit:** 
- **Value:** 10.6
**Title:** 
## Results Section
### Outcome Measures Module
#### Outcome Measure 1
**Description:** 7 performance measures: angiotensin converting enzyme inhibitor and/or angiotensin II receptor blockers (ACEI/ARB), beta-blokers, aldosterone receptor antagonists, anticoagulation for atrial fibrillation (AF), cardiac resynchronization therapy (CRT-P/CRT-D), cardioverter-defibrillator (ICD/CRT-D), heart failure (HF) education.

We first calcuated % of patients who were eligible for a performance measure that were treated by it at baseline and 24 months. We then calculated the relative change as (% treated at 24 months - % treated at baseline)/% treated at baseline. The 95% confidence interval (CI) was calculated and the relative change of each performance measure was evaluated using a z-test for one-sample proportion.

The number of performance measures with \>= 20% relative improvement was determined. The intervention was considered successful if a relative 20% or greater improvement in at least 2 of the 7 performance measures at 24 months compared with baseline was achieved.
**Dispersion Type:** 95% Confidence Interval
**Parameter Type:** NUMBER
**Population Description:** 167 practices contributed data to the baseline chart review. Twelve of the practices withdrew from the study prior to the next chart review milestone. 155 of those practices' data contributed to the follow up of the longitudinal cohort time points of 12 and 24 months post educational workshop.
**Reporting Status:** POSTED
**Time Frame:** 24 Month
**Title:** To Evaluate Over the Aggregate IMPROVE-HF Practice Sites the Relative Changes in 7 Performance Measures at 24 Months Compared With Baseline and Determine the Number of Performance Measures That Achieved a Relative 20% or Greater Positive Change.
**Type:** PRIMARY
**Unit of Measure:** percentage of participants in aggregate
##### Group
**Description:** For this longitudinal cohort, data are collected at baseline, 12 months and 24 months after the principle investigator and HF nurse attend an educational workshop. All longitudinal analyses will be performed on this cohort of patients. This arm includes all the atients at baseline. Percentage of patients who were eligible for a performance measure that were treated by it at baseline was calculated.
**ID:** OG000
**Title:** Cohort A (at Baseline)
##### Group
**Description:** For this longitudinal cohort, data are collected at baseline, 12 months and 24 months after the principle investigator and HF nurse attend an educational workshop. All longitudinal analyses will be performed on this cohort of patients. This arm includes the completers, i.e. patients who have a qualifying visit at both baseline and 24 months who were living at the 24 month chart review and are qualified for at least one performance measure at 24 months. Percentage of the patients who were eligible for a performance measure that were treated by it at the 24 months was calculated.
**ID:** OG001
**Title:** Cohort A (at 24 Months)
##### Group
**Description:** For this longitudinal cohort, data are collected at baseline, 12 months and 24 months after the principle investigator and HF nurse attend an educational workshop. All longitudinal analyses will be performed on this cohort of patients. This arm includes the completers, i.e. patients who have a qualifying visit at both baseline and 24 months who were living at the 24 month chart review and are qualified for at least one performance measure at 24 months. The relative changes in the percentages from 24 months to baseline were calculated for the 7 performance measures.
**ID:** OG002
**Title:** Cohort A (Relative Change 24 Months vs. Baseline)
#### Outcome Measure 2
**Description:** The number of practices that achieved greater than or equal to 20% improvement in two or more of the 7 performance measures at 24 months as compared to baseline of cohort A is presented.
**Parameter Type:** NUMBER
**Reporting Status:** POSTED
**Time Frame:** 24 months
**Title:** Observe the Number of Sites That Demonstrate a Relative 20% or Greater Improvement in 2 or More of the 7 Performance Measures at 24 Months as Compared to Baseline in Cohort A.
**Type:** SECONDARY
**Type Units Analyzed:** Sites
**Unit of Measure:** Sites
##### Group
**Description:** In this analysis, 167 practices contributed data to the baseline chart review of Cohort A. Of them, 12 practices withdrew from the study prior to the next chart review milestone. Therefore, 155 practices' data contributed to the follow up of the longitudinal cohort time points of 12 and 24 months post educational workshop. Correspondingly there were 7605 patients whose chart review was completed at both baseline and 24 months.
**ID:** OG000
**Title:** Practice Sites in Cohort A
#### Outcome Measure 3
**Description:** performance measure improvement for each performance measure was analyzed at a practice level from baseline to 24 months. Performance measure adherence was calculated at the individual practice level and then combined and summarized. Mean, standard deviation, and 95% confidence intervals for performance measure adherence, composite score and relative change (24 months compared with baseline) are reported.

The Composite Score is based on the ratio of the sum of the numerators of all individual performance measures to the sum of the denominators of all individual performances measures. The numerator of a performance measure is the number of patients treated with that measure. The denomiator of a performance measure is the number of patients eligible for being treated with that measure.
**Dispersion Type:** Standard Deviation
**Parameter Type:** MEAN
**Reporting Status:** POSTED
**Time Frame:** 24 months
**Title:** Observe the Change From Baseline to 24 Months in Each Performance Measure and Composite Score for the Aggregate Practices.
**Type:** SECONDARY
**Type Units Analyzed:** Sites
**Unit of Measure:** percentage
##### Group
**Description:** Cohort A at baseline included 15177 patients from 167 study sites (practices).
**ID:** OG000
**Title:** Cohort A (at Baseline)
##### Group
**Description:** Cohort A at 24 months included 7605 patients from 155 study sites (practices).
**ID:** OG001
**Title:** Cohort A (at 24 Months)
##### Group
**Description:** The ralative changes in performance measures and compsite score at 24 months compared to baseline were calculated based on 155 study sites that involved 7605 patients.
**ID:** OG002
**Title:** Cohort A (Relative Change 24 Months vs. Baseline)
#### Outcome Measure 4
**Description:** The relative changes between baseline of cohort A and 6 months of cohort B in performance measures and composite score for the aggregate practices were calculated using mean, standard deviation and 95% CI.
**Dispersion Type:** Standard Deviation
**Parameter Type:** MEAN
**Reporting Status:** POSTED
**Time Frame:** Baseline and 6 Months
**Title:** Observe the Relative Change Between Baseline of Cohort A and 6 Months of Cohort B in Performance Measures and Composite Score for the Aggregate Practices.
**Type:** SECONDARY
**Type Units Analyzed:** Sites
**Unit of Measure:** percentage of participants
##### Group
**Description:** In this analysis, data of Cohort A at baseline were used. This included 15177 patients from 167 cardiology practices.
**ID:** OG000
**Title:** Cohort A: Baseline
##### Group
**Description:** In this analysis, data of Cohort B (i.e. 6 months single time point cohort) were used. This included 9992 patients from 154 cardiology practices.
**ID:** OG001
**Title:** Cohort B: 6 Months
##### Group
**Description:** The relative changes in performance measures and composite score of Cohort B (6 months) compared with those of Cohort A at baseline were calculated
**ID:** OG002
**Title:** Cohort B 6 Months vs. Cohort A Baseline (Relative Change)
#### Outcome Measure 5
**Description:** The relative changes between baseline of cohort A and 18 months of cohort C in performance measures and composite score for the aggregate practices were calculated using mean, standard deviation and 95% CI.
**Dispersion Type:** Standard Deviation
**Parameter Type:** MEAN
**Reporting Status:** POSTED
**Time Frame:** baseline and 18 Months
**Title:** Observe the Relative Change Between Baseline of Cohort A and 18 Months of Cohort C in Performance Measures and Composite Score for the Aggregate Practices.
**Type:** SECONDARY
**Type Units Analyzed:** Sites
**Unit of Measure:** percentage of participants
##### Group
**Description:** In this analysis, data of Cohort A at baseline were used. This included 15177 patients from 167 cardiology practices.
**ID:** OG000
**Title:** Cohort A: Baseline
##### Group
**Description:** In this analysis, data of Cohort C (i.e. 18 months single time point cohort) were used. This included 9641 patients from 150 cardiology practices.
**ID:** OG001
**Title:** Cohort C (18 Months)
##### Group
**Description:** The relative changes in performance measures and composite score of Cohort C (18 months) compared with those of Cohort A at baseline were calculated.
**ID:** OG002
**Title:** Cohort C 18 Months vs. Cohort A Baseline (Relative Change)
### Participant Flow Module
#### Group
**Description:** Cohort A: The charts of 15,177 patients were reviewed at baseline, 12 months and 24 months. The principal investigator and HF nurse of the study sites attended an educational workshop at baseline, 12 and 24 months as well where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort A is a longitudinal cohort.
**ID:** FG000
**Title:** Cohort A (Baseline, 12 and 24 Months)
#### Group
**Description:** Cohort B: The charts of 9,992 patients were reviewed at 6 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort B is a single time point cohort.
**ID:** FG001
**Title:** Cohort B (6 Months)
#### Group
**Description:** Cohort C: The charts of 9,641 patients were reviewed at 18 months. The principal investigator and HF nurse of the study sites attended an educational workshop at the same time where they were provided with tools meant to improve HF care at their practices. The tools included tip cards, worksheets, and patient education materials. Cohort C is a single time point cohort.
**ID:** FG002
**Title:** Cohort C (18 Months)
#### Period
**Title:** Overall Study
##### Milestone
**Type:** STARTED
###### Achievement
**Group ID:** FG000
**Number of Subjects:** 15177
###### Achievement
**Group ID:** FG001
**Number of Subjects:** 9992
###### Achievement
**Group ID:** FG002
**Number of Subjects:** 9641
##### Milestone
**Type:** COMPLETED
###### Achievement
**Group ID:** FG000
**Number of Subjects:** 7605
###### Achievement
**Group ID:** FG001
**Number of Subjects:** 9992
###### Achievement
**Group ID:** FG002
**Number of Subjects:** 9641
##### Milestone
**Type:** NOT COMPLETED
###### Achievement
**Group ID:** FG000
**Number of Subjects:** 7572
###### Achievement
**Group ID:** FG001
**Number of Subjects:** 0
###### Achievement
**Group ID:** FG002
**Number of Subjects:** 0
**Pre-Assignment Details:** The study included 3 mutually exclusive patient cohorts. Patients in cohort A were reviewed at baseline, 12 and 24 months. This is also called the longitudinal cohort. Patients in cohort B and C were reviewed at 6 and 18 months, respectively. These two cohorts are referred to as the single time point cohorts.
**Recruitment Details:** The study sites included outpatient cardiology practices in the United States. Patients diagnosed with heart failure or prior myocardial infarction or developed moderate-severe left ventricular dysfunction were included. Each cardiology practice had five chart reviews and an educational workshop as a part of the process improvement intervention.
**Has Results:** True