On the wall of his office, John Spertus, M.D., M.P.H., displays three documents framed side by side. They are a perfect representation of his work in developing measurement tools to quantify patient symptoms, function and quality of life in dealing with cardiovascular disease, not to mention his nearly 20 years as an instructor in the School of Medicine.
The first document is a 2000 journal article about the Kansas City Cardiomyopathy Questionnaire, which Spertus created. The second is a line graph that skyrockets upwards, showing how often that article has been cited — more than 900 times between 2000 and 2017. The third is a 2017 letter from the Federal Drug Administration qualifying the questionnaire to be used in clinical trials to approve new devices for heart disease.
“Nobody thought what we were doing was important when we started,” Spertus says. “In the scientific community it wasn’t considered real science.”
That’s not the case now. The measurement tools he and his research group developed have been translated into nearly 100 languages for use throughout the world.
The Kansas City Cardiomyopathy Questionnaire and the Seattle Angina Questionnaire are just two of the tools he created to guide physicians and patients in their medical decision-making. Both are recognized by experts around the world as the gold standards for measuring patients’ symptoms, function and quality of life in coronary artery disease and heart failure.
“Our group has spent a lot of time looking at variations in care, trying to figure out if the care we’re giving is appropriate for the patient, based on their risks and benefits, or if it’s really reflecting the doctor’s preference rather than the patient’s,” Spertus says. “Once you have a good measurement system, you can try to change the way you deliver care and see if it makes things better. That’s what our group is committed to doing.”
Spertus first became interested in this type of research when he observed that evolving treatment strategies for heart patients seemed more focused on technical endpoints and less on the individual patient.
“It seemed to me like an egregious wrong that when we were testing new therapies, we weren’t figuring out if these therapies made the patients feel better or not,” Spertus says.
“That bothered me.”
He set out to change the way medicine looks at patients and developed his first questionnaire as a measurement tool for coronary disease in 1992. Now, Medicare is looking at using one of his questionnaires as a quality measure for angioplasty patients. Two years ago, the FDA certified one of his tools so drug companies using the questionnaire to show a benefit from their product can legally make the claim the product improves symptoms or function of heart patients.
The American Heart Association has also recognized Spertus’ efforts with three major awards: the Distinguished Scientist Award, a Lifetime Achievement Award and the Council on Quality of Care and Outcomes Research Distinguished Achievement Award.
Now, after more than 20 years describing patient and treatment characteristics associated with patient-centered outcomes and guiding clinical trials to measure those outcomes, Spertus says he is refocusing his efforts to improve health care in Kansas City, specifically. He and his research team have engaged 14 of the region’s hospitals and health-care entities to form the Quality and Value Innovation Consortium, a unique collaboration to explore and implement new strategies in the delivery of care.
During the past year, Spertus looked at nearly 40 projects these health-care groups were using to improve their care. He found two overlapping issues of concern on which the consortium will initially focus its attention: addressing the opioid epidemic and transitions of care to reduce 30-day readmission rates for heart failure patients.
Each of those projects will have a team of four researchers engaging a cohort of six to 10 hospitals to implement and evaluate new and different strategies.
“What’s novel about this project is that we’re getting all of these different hospitals to collaborate and engage in trying different strategies to figure out what works and what doesn’t,” Spertus says. “We’re hoping to build a culture of collaboration in the region. While the hospitals compete for patients, they can all collaborate on safety and delivering high value health care.”
Spertus says he wants to finish his career by implementing everything he and his research group have learned over the years through projects like the Quality and Value Innovation Consortium.
“My hope is that UMKC will be able to continue to support and sustain this effort,” he says. “It’s very gratifying because it’s giving back to our community. This isn’t just about building a research infrastructure. We’re trying to make a difference in Kansas City.”