The value of diagnostic information in Heart Failure

Virtual panel discussion with experts across the EU

We hosted a virtual panel discussion on The Value of Diagnostic Information (VODI) where we gathered experts with various specialties, ready to share their insights. In the webinar we explored policies and changes that need to be made to capture the outcome of diagnostic information and improve heart failure management.

Our panel:

• Professor Dr Yigal M Pinto (Heart Centre at the Academic Medical Centre, the Netherlands)
  
• Professor Damien Gruson (Cliniques universitaires Saint-Luc, Belgium; Member of the European Commission’s Expert Panel)
  
• Mr Nick Hartshorne-Evans (Founder and Chief Executive of Pumping Marvellous Foundation, UK)
  
• Dr Bernarda Zamora (Office of Health Economics, UK)
  
• Ms Carys Barton (Imperial College Healthcare NHS Trust, UK;  British Society for Heart Failure Nurse Forum)
  
• Ms Sophie Meiser (MedTech Europe), moderated by Mr Ed Harding (Network Director of the Heart Failure Policy Network)
  

Whereas therapeutic value can be measured as the direct clinical benefit for the patient, this is not the case for diagnostics

Our host Ms. Meiser, during her introduction of the panel, said: “Whereas therapeutic value can be measured as the direct clinical benefit for the patient, this is not the case for diagnostics, despite their importance to clinical decision-making”. She continued, “This is a challenge we must embrace if we are to truly realise the benefits of diagnostics and the contribution to longer-term sustainability in response to population ageing, the increasing prevalence of chronic conditions and, more recently, the COVID-19 pandemic.”

Dr. Zamora continued, by introducing the VODI framework as a possible answer to the existing challenge: “The VODI framework outlines how to define and measure the value of outcomes created by IVD’s, and how to incorporate this information into decision-making processes. It aims to identify the multi-faceted value of IVD’s to relevant stakeholders (see Figure 1).”

Professor Pinto raised an essential question when it comes to heart failure (HF) management: Pinto said: “Which diagnostics are most valuable in the field of HF? HF is a syndrome and not a disease, which makes it more difficult to measure. In addition, the number and complexity of treatment options for HF have grown, amplifying the need for diagnostic parameters to guide clinical decision-making. While new treatments have demonstrated considerable survival benefits in clinical trials, it is much more difficult to determine treatment benefit in real-world settings. This may result in overtreatment – for example, 85% of implantable cardioverter-defibrillators given to people living with HF will never intervene.”

Professor Gruson shared his own perspective on the importance of diagnostic testing: “Laboratory tests not only help to diagnose people with heart failure, but also help to profile patients for the appropriate use of hospital services.” he said. And continued: “The development of innovative sensors, similar to those in diabetes, will support the continuous monitoring of biomarkers in HF. This information, coupled with clinical data, can improve diagnosis and enhance precision care, leading to improvements in cardiovascular health and substantial cost savings.”

The event concluded with an engaging and lively discussion, answering some important questions raised by the audience:

1. How do we measure patient-reported outcomes, and what are the challenges in implementation?
   
2. How can we use patient-reported outcomes and diagnostic information to improve the lives of people with HF?
   
3. What is required to capture the value of diagnostic information in a structured and consistent way?
   
4. Which hurdles do you encounter in capturing the value of diagnostic information?
   
5. How do we incentivise the use of diagnostics in HF?
   
6. Can we use NT-proBNP as a surrogate endpoint for safety or efficacy in clinical trials in HF?
   
7. What should we do with diagnostic information in HF when no effective treatment is available (e.g. in HF with preserved ejection fraction, HFpEF)?
   
8. How would you communicate the value of diagnostic information in HF to a decision-maker?
   

Listen to the full recording of the digital event and find out how you can make an even greater impact to more efficient healthcare delivery in heart failure.