This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Drug Therapy, Other  • Prognosis/ Outcomes  • Congestive Heart Failure/ Cardiomyopathy  • Treatment Adherence  • Adherence  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In their analysis of the OPTIMIZE-HF registry database, Dr Fonarow and colleagues¹ raise important issues regarding the development of national clinical quality performance measures.

Such measures are developed to assess patterns of care known to affect patient outcomes, in order to support quality improvement. The strongest, most meaningful, and most durable performance measures are based on the highest level of clinical research evidence, derived directly from published clinical guidelines that provide a balanced impartial review of the existing evidence base. Only those guideline recommendations with the strongest level of evidence are appropriate for performance measure development.

The ACC/AHA performance measures for care of patients with heart failure² include prescription of an angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) for patients with depressed systolic function. Fonarow et al have shown a substantial reduction in short-term adverse clinical outcomes in patients treated with these agents, consistent with . . . [Full Text of this Article]

Martha J. Radford, MD
martha.radford@nyumc.org
New York University School of Medicine
New York

Robert O. Bonow, MD
Northwestern University Feinberg School of Medicine
Chicago, Ill

Raymond J. Gibbons, MD
Mayo Clinic College of Medicine
Rochester, Minn

Steven E. Nissen, MD
Cleveland Clinic Foundation
Cleveland, Ohio

RELATED LETTERS

Performance Measures and Outcomes for Patients Hospitalized With Heart Failure
Mehdi H. Shishehbor and David Litaker
JAMA. 2007;297(14):1547.
EXTRACT | FULL TEXT  

Performance Measures and Outcomes for Patients Hospitalized With Heart Failure—Reply
Gregg C. Fonarow, Clyde W. Yancy, William T. Abraham, and Barry H. Greenberg
JAMA. 2007;297(14):1548-1549.
EXTRACT | FULL TEXT  

RELATED ARTICLE

Association Between Performance Measures and Clinical Outcomes for Patients Hospitalized With Heart Failure
Gregg C. Fonarow, William T. Abraham, Nancy M. Albert, Wendy Gattis Stough, Mihai Gheorghiade, Barry H. Greenberg, Christopher M. O’Connor, Karen Pieper, Jie Lena Sun, Clyde Yancy, James B. Young, and for the OPTIMIZE-HF Investigators and Hospitals
JAMA. 2007;297(1):61-70.
ABSTRACT | FULL TEXT