{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:34:00Z","timestamp":1787960040998,"version":"build-2784847793"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2020,11,7]],"date-time":"2020-11-07T00:00:00Z","timestamp":1604707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"SAG"},{"DOI":"10.13039\/501100000266","name":"Engineering and Physical Sciences Research Council","doi-asserted-by":"publisher","award":["EP\/P010148\/1"],"award-info":[{"award-number":["EP\/P010148\/1"]}],"id":[{"id":"10.13039\/501100000266","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013235","name":"Greater Manchester Patient Safety Translational Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013235","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NHS"},{"DOI":"10.13039\/100006662","name":"NIHR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003921","name":"Department of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003921","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,5,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Recent studies showed that exercise-based cardiac rehabilitation (ECR) programmes are often not personalized to individual patient characteristics according to latest recommendations. This study investigates whether a computerized decision support (CDS) system based on latest recommendations and guidelines can improve personalization of ECR prescriptions. Pseudo-randomized intervention study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Among participating Dutch cardiac rehabilitation centres, ECR programme characteristics of consecutive patients were recorded during 1 year. CDS was used during a randomly assigned 4-month period within this year. Primary outcome was concordance to latest recommendations in three phases (before, during, and after CDS) for 12 ECR programme characteristics. Secondary outcome was variation in training characteristics. We recruited ten Dutch CR centres and enrolled 2258 patients to the study. Overall concordance of ECR prescriptions was 59.9% in Phase 1, 62.1% in Phase 2 (P\u2009=\u20090.82), and 59.9% in Phase 3 (P\u2009=\u20090.56). Concordance varied from 0.0% to 99.9% for the 12 ECR characteristics. There was significant between-centre variation for most training characteristics in Phases 1 and 2. In Phase 3, there was only a significant variation for aerobic and resistance training intensity (P\u2009=\u20090.01), aerobic training volume (P\u2009&amp;lt;\u20090.01), and the number of strengthening exercises but no longer for the other characteristics. Aerobic training volume was often below recommended (28.2%) and declined during the study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>CDS did not substantially improve concordance with ECR prescriptions. As aerobic training volume was often lower than recommended and reduced during the study, a lack of institutional resources might be an important barrier in personalizing ECR prescriptions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaa066","type":"journal-article","created":{"date-parts":[[2021,1,1]],"date-time":"2021-01-01T04:13:55Z","timestamp":1609474435000},"page":"572-580","source":"Crossref","is-referenced-by-count":9,"title":["A computerized decision support system did not improve personalization of exercise-based cardiac rehabilitation according to latest recommendations"],"prefix":"10.1093","volume":"28","author":[{"given":"Tom","family":"Vromen","sequence":"first","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC, Location AMC, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands"},{"name":"Department of Cardiology, Maastricht University Medical Center, P.O. Box 616, 6200 MD, Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels B","family":"Peek","sequence":"additional","affiliation":[{"name":"Health e-Research Centre, Farr Institute of Health Informatics Research, University of Manchester, Vaughan HousePortsmouth Street, Manchester M13 9GB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameen","family":"Abu-Hanna","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics, Amsterdam UMC, Location AMC, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Kornaat","sequence":"additional","affiliation":[{"name":"Department of Cardiac Rehabilitation, Rijnlands Rehabilitation Centre, Wassenaarseweg 501, 2333AL, Leiden, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hareld M","family":"Kemps","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Maxima Medical Centre, De Run 4600, 5504 DB, Veldhoven, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,7]]},"reference":[{"key":"2021051419091046200_zwaa066-B1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease: cochrane systematic review and meta-analysis","volume":"67","author":"Anderson","year":"2016","journal-title":"J Am Coll Cardiol"},{"key":"2021051419091046200_zwaa066-B2","first-page":"CD003331","article-title":"Exercise based rehabilitation for heart failure","volume":"4","author":"Davies","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"2021051419091046200_zwaa066-B3","doi-asserted-by":"crossref","first-page":"1914","DOI":"10.1177\/2047487316671181","article-title":"The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: a systematic review and meta-analysis of randomized and non-randomized studies\u2014the Cardiac Rehabilitation Outcome Study (CROS)","volume":"23","author":"Rauch","year":"2016","journal-title":"Eur J Prev Cardiol"},{"key":"2021051419091046200_zwaa066-B4","doi-asserted-by":"crossref","DOI":"10.1177\/2047487320905719","article-title":"Effectiveness of comprehensive cardiac rehabilitation in coronary artery disease patients treated according to contemporary evidence based medicine: Update of the Cardiac Rehabilitation Outcome Study (CROS-II)","author":"Salzwedel","year":"2020","journal-title":"Eur J Prev Cardiol"},{"key":"2021051419091046200_zwaa066-B5","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1161\/01.CIR.0000151788.08740.5C","article-title":"Cardiac rehabilitation and secondary prevention of coronary heart disease: an American heart association scientific statement from the council on clinical cardiology (subcommittee on exercise, cardiac rehabilitation, and prevention) and the council on nutrition, physical activity, and metabolism (subcommittee on physical activity), in collaboration with the American association of cardiovascular and pulmonary rehabilitation","volume":"111","author":"Leon","year":"2005","journal-title":"Circulation"},{"key":"2021051419091046200_zwaa066-B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/HJR.0b013e3283313592","article-title":"Secondary prevention through cardiac rehabilitation: from knowledge to implementation. 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