Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Doenças Cardiovasculares/reabilitação , Terapia por Exercício , Consenso , Educação de Pacientes como AssuntoRESUMO
PURPOSE: Cardiac rehabilitation (CR) programs decrease morbidity and mortality rates in patients with coronary artery disease, the leading cause of death in Latin America. This study was carried out to assess the characteristics and current level of CR program implementation in South America. METHODS: We carried out a survey of CR programs that were identified using the directory of the South American Society of Cardiology and through an exhaustive search by the investigators. RESULTS: We identified 160 CR programs in 9 of the 10 countries represented in the South American Society of Cardiology and 116 of those responded to our survey. On the basis of survey results from the responding programs, we estimate that the availability of CR programs in South America is extremely low, approximately 1 CR program for every 2 319 312 inhabitants. These CR programs provided services to a median of 180 patients per year (interquartile range, 60-400) and were most commonly led by cardiologists (84%) and physical therapists (72%). Phases I, II, III, and IV CR were offered in 49%, 91%, 89%, and 56% of the centers, respectively. The most commonly perceived barrier to participation in a CR program was lack of referral from the cardiologist or primary care physician, as reported by 70% of the CR program directors. CONCLUSIONS: The number of CR programs in South America appears to be insufficient for a population with a high and growing burden of cardiovascular disease. In addition, there appears to be a significant need for standardization of CR program components and services in the region.
Assuntos
Reabilitação Cardíaca , Cardiologia/organização & administração , Pesquisas sobre Atenção à Saúde , Acessibilidade aos Serviços de Saúde/normas , Necessidades e Demandas de Serviços de Saúde/normas , Desenvolvimento de Programas , Centros de Reabilitação/estatística & dados numéricos , Idoso , Doenças Cardiovasculares/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Sociedades Médicas , América do Sul/epidemiologiaRESUMO
Cardiovascular risk assessment in patients without established disease allows to match the intensity of risk factor modification to the underlying hazard for cardiovascular events. The cardiologist needs to know the characteristics of current risk prediction algorithms, their advantages and limitations.
Assuntos
Doenças Cardiovasculares/epidemiologia , Medição de Risco , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
La estimación del riesgo cardiovascular basal de un paciente sin enfermedad establecida, permite ajustar la intensidad de la intervención preventiva de acuerdo a la probabilidad de desarrollar complicaciones cardiovasculares. El cardiólogo necesita conocer las características de los modelos de predicción de riesgo CV disponibles, sus ventajas y limitaciones.
Cardiovascular risk assessment in patients without established disease allows to match the intensity of risk factor modification to the underlying hazard for cardiovascular events. The cardiologist needs to know the characteristics of current risk prediction algorithms, their advantages and limitations.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Cardiovasculares/epidemiologia , Medição de Risco , Medicina Baseada em EvidênciasRESUMO
This article reviews different characteristics of validity in a clinical diagnostic test. In particular, we emphasize the likelihood ratio as an instrument that facilitates the use of epidemiologic concepts in clinical diagnosis.
Assuntos
Técnicas de Diagnóstico Cardiovascular/estatística & dados numéricos , Cardiopatias/diagnóstico , Adulto , Cardiologia , Epidemiologia , Medicina Baseada em Evidências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Probabilidade , Sensibilidade e EspecificidadeRESUMO
Este artículo revisa de manera práctica las diferentes características de validez de una prueba diagnóstica. En particular, se destaca la razón de probabilidad como una herramienta que facilita el uso de conceptos epidemiológicos en el diagnóstico clínico.
This article reviews different characteristics of validity in a clinical diagnostic test. In particular, we emphasize the likelihood ratio as an instrument that facilitates the use of epidemiologic concepts in clinical diagnosis.