Massive data collections derived from millions of daily interactions within the health care system are increasingly available, but we urgently need more advanced tools to support research that can produce better personalized predictions about prognosis and response to treatments; a deeper understanding of the complex factors and their interactions that influence health at the level of the patient, the health system, and society; and more effective methods of causal inference, mitigating bias and error. We also need to find new ways to think about data, while promoting its value for individuals and organizations in the service of promoting better decisions and outcomes. Accordingly, we have assembled a remarkable team of world-class experts with complementary skills who are dedicated to deep collaboration in order to produce high impact methods and tools, primed for widespread use, that will unleash the information potential of data produced as part of routine health care delivery.
Ongoing and completed projects at CORE include:
Our Quality Measurement Group's ongoing work with the Centers for Medicare & Medicaid Services (CMS) includes new measure development, research on hospital quality including evaluation of trends, disparities and geographic variation and communications with stakeholders about hospital quality, and potential expansion of outcomes measures to other health care settings.
In 2010, the National Heart, Lung, and Blood Institute of the National Institutes of Health established a Center for Cardiovascular Outcomes Research at Yale University, one of three identified after a national competition. CCOR’s 4-year grant will provide the research infrastructure to develop a national surveillance program for cardiovascular care and outcomes.
Hospitalomics, funded by a 4-year Donaghue Foundation grant, is a multi-disciplinary data-driven approach that combines systems thinking, outcomes sciences, and information sciences to generate information on variation in hospital care and to identify those patterns of care that are strongly associated with the best performance as measured by clinical outcomes (mortality and readmission rates) and hospital costs.
The YODA Project advocates for the responsible sharing of clinical research data. The Project is committed to open science and data transparency, and supports research attempting to produce concrete benefits to patients, the medical community, and society as a whole. Through experience and input from the public and stakeholders, the YODA Project has iteratively developed a model to make data available to researchers in a sustainable way, in which data sharing becomes a part of the clinical research enterprise of the future. The mission of the YODA Project is to not only increase access to clinical research data, but to promote its use to generate new knowledge.
The surveillance of medical devices is intended to provide critical information to all relevant stakeholders about device safety, long-term product performance, and effectiveness in improving patient outcomes. However, we are far from this ideal system. Yale University, in partnership with Medtronic, Inc., has been selected to receive a five-year cooperative agreement from the U.S. Food and Drug Administration (FDA) that will develop methods and facilitate best practices for medical device surveillance.
Tele-HF is the largest randomized controlled trial to study the effectiveness of telemonitoring on heart failure outcomes.
Women 55 years and younger have about twice the risk of death from a heart attack than similarly aged men. Our VIRGO group has been funded by the National Institutes of Health to examine predictors of a broad range of early and 1-year outcomes for young women with heart attacks and to examine such questions as: Do women get the same quality of care as men?
The objective of the Global Health initiative is to strengthen the health care systems for cardiovascular disease around the world, with a current focus on China.
Since 2007, Yale CORE has served as an analytic center for the ICD RegistryTM and the CathPCI Registry® of the American College of Cardiology Foundation’s National Cardiovascular Data Registry (NCDR®). More recently, the ACTION Registry® was added. The goal of this work is to generate new knowledge and insights into the care of patients with cardiovascular disease through analysis of the robust data submitted to the NCDR® registries. A team of CORE researchers work closely with NCDR® staff to provide logistical and analytical support for research proposals related to its ICD Registry®, CathPCI RegistryTM and ACTION Registry®.