Background

Accuracy of New York Heart Association Functional Classification (NYHA-FC) I-IV assessment is critical to promoting guideline directed care.

Objective

Examine providers’ accuracy when diagnosing NYHA-FC I-IV in patients with heart failure (HF).

Methods

A web-based survey using validated vignettes was conducted with 244 physicians, nurse practitioners (NP), clinical nurse specialists (CNS) and physician assistants (PA) who provide care to patients with HF.

Results

Providers comprised of 65% NPs, 19% physicians, 14% CNSs, 2% PAs with an average of 15 years working with HF patients. Accuracy ranged from 36.9% for Class IV to 78.7% for Class I. Increased HF patient volume seen (p=0.024), physician vs. NP/PA/CNS (p=0.021), and typically assigned a HF stage (p<0.001) were associated with increased total correct score accuracy in multivariable modeling.

Conclusion

It is critical that NYHA-FC is accurately assigned to promote optimal outcomes. Research in the future should focus on improving accuracy in assigning NYHA-FC.

中文翻译：

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提供者对心力衰竭患者的 NYHA 功能分级的分配：一项小插曲研究

背景

纽约心脏协会功能分类 (NYHA-FC) I-IV 评估的准确性对于促进指导性护理至关重要。

客观的

检查提供者在诊断心力衰竭 (HF) 患者的 NYHA-FC I-IV 时的准确性。

方法

对 244 名为心衰患者提供护理的医生、执业护士 (NP)、临床护士专家 (CNS) 和医师助理 (PA) 进行了一项使用经过验证的小插曲的网络调查。

结果

提供者由 65% 的 NP、19% 的医生、14% 的 CNS、2% 的 PA 组成，平均与 HF 患者合作 15 年。准确度范围从 IV 类的 36.9% 到 I 类的 78.7%。所见 HF 患者数量增加 (p=0.024)，医生与 NP/PA/CNS (p=0.021)，通常分配一个 HF 阶段 (p<0.001 ) 与多变量建模中总正确分数准确性的提高有关。

结论

准确分配 NYHA-FC 以促进最佳结果至关重要。未来的研究应侧重于提高分配 NYHA-FC 的准确性。