{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T17:27:54Z","timestamp":1765733274887,"version":"3.48.0"},"reference-count":35,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T00:00:00Z","timestamp":1710374400000},"content-version":"unspecified","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Ted Rogers Centre for Heart research","award":["Post-doctoral Fellowship funding"],"award-info":[{"award-number":["Post-doctoral Fellowship funding"]}]},{"name":"Qatar University International Research Collaboration Co-Fund","award":["IRCC-2022-601"],"award-info":[{"award-number":["IRCC-2022-601"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,2,28]]},"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There are substantial variations in entry criteria for heart failure (HF) clinics, leading to variations in whom providers refer for these life-saving services. This study investigated actual versus ideal HF clinic inclusion or exclusion criteria and how that related to referring providers' perspectives of ideal criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>Two cross-sectional surveys were administered via research electronic data capture to clinic providers and referrers (eg, cardiologists, family physicians and nurse practitioners) across Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measures<\/jats:title>\n                    <jats:p>Twenty-seven criteria selected based on the literature and HF guidelines were tested. Respondents were asked to list any additional criteria. The degree of agreement was assessed (eg, Kappa).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Responses were received from providers at 48 clinics (37.5% response rate). The most common actual inclusion criteria were newly diagnosed HF with reduced or preserved ejection fraction, New York Heart Association class IIIB\/IV and recent hospitalisation (each endorsed by &gt;74% of respondents). Exclusion criteria included congenital aetiology, intravenous inotropes, a lack of specialists, some non-cardiac comorbidities and logistical factors (eg, rurality and technology access). There was the greatest discordance between actual and ideal criteria for the following: inpatient at the same institution (\u03ba=0.14), congenital heart disease, pulmonary hypertension or genetic cardiomyopathies (all \u03ba=0.36). One-third (n=16) of clinics had changed criteria, often for non-clinical reasons. Seventy-three referring providers completed the survey. Criteria endorsed more by referrers than clinics included low blood pressure with a high heart rate, recurrent defibrillator shocks and intravenous inotropes\u2014criteria also consistent with guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>There is considerable agreement on the main clinic entry criteria, but given some discordance, two levels of clinics may be warranted. Publicising evidence-based criteria and applying them systematically at referral sources could support improved HF patient care journeys and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076664","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T23:00:57Z","timestamp":1710457257000},"page":"e076664","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Heart failure clinic inclusion and exclusion criteria: cross-sectional study of clinic\u2019s and referring provider\u2019s perspectives"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1066-0139","authenticated-orcid":false,"given":"Taslima","family":"Mamataz","sequence":"first","affiliation":[{"name":"Faculty of Health, York University, Keele Campus, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean A","family":"Virani","sequence":"additional","affiliation":[{"name":"Medicine, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"McDonald","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre, University of Toronto, University Health Network, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Edgell","sequence":"additional","affiliation":[{"name":"Faculty of Health, York University, Keele Campus, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-3610","authenticated-orcid":false,"given":"Sherry L","family":"Grace","sequence":"additional","affiliation":[{"name":"Faculty of Health, York University, Keele Campus, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"2025121409224864000_14.3.e076664.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.11.010"},{"key":"2025121409224864000_14.3.e076664.2","doi-asserted-by":"crossref","first-page":"3272","DOI":"10.1093\/cvr\/cvac013","article-title":"Global burden of heart failure: a comprehensive and updated review of epidemiology","volume":"118","author":"Savarese","year":"2023","journal-title":"Cardiovasc Res"},{"key":"2025121409224864000_14.3.e076664.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.08.022"},{"key":"2025121409224864000_14.3.e076664.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"2025121409224864000_14.3.e076664.5","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.cjco.2022.04.011","article-title":"The state of heart failure care in Canada: minimal improvement in Readmissions over time despite an increased number of evidence-based therapies","volume":"4","author":"Poon","year":"2022","journal-title":"CJC Open"},{"key":"2025121409224864000_14.3.e076664.6","unstructured":"Ontario Health . 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