Early Assessment and Initiation of GuideLine-Directed Evidence-Based Management-HF

New onset HF based on race

Race (a categorical variable) may be reduced to white vs. all other if other categories have too low a sample size. New-onset heart failure is based on electronic health record documentation of elevated NTproBNP and/or echocardiography results + patient symptoms.

New onset HF based on social vulnerability index

SVI (national data based on zip code) Scores range from 0 to 1, with lower scores equating to less social vulnerability. Note: scores may be categorized into SVI factors are socioeconomic status, household characteristics, racial and ethnic minority status, and housing type and transportation that has 4 categories from low vulnerability to high vulnerability). New onset heart failure is based on electronic health record documentation of elevated NTproBNP and/or echocardiography results + patient symptoms.

New onset HF based on marital status

Marital status (a categorical variable that may be reduced to married vs. not married) if other categories have too low of a sample size. New onset heart failure is based on electronic health record documentation of elevated NTproBNP and/or echocardiography results + patient symptoms.

New onset HF based on patients comfort living on income

Comfort living on income is a single patient reported outcome measure with 3 response options: less than comfortable, comfortable, more than comfortable.New onset heart failure is based on electronic health record documentation of elevated NTproBNP and/or echocardiography results + patient symptoms.

Use of HFrEF core medication classes based on distressed community index (DCI)

DCI score (0-100) comes from a national database that uses zip code to determine community distress (previously described). HFrEF medication "use" score is based on prescription of core 4 classes of medications per the electronic health record: 1) renin-angiotensin system inhibitors (RASi) or hydralazine/nitrate if severe chronic kidney disease or other contraindication, 2) evidenced-based beta blockers (eBB) or ivabradine if beta blockers are contraindicated), 3) mineralocorticoid receptor blocker (MRA), and 4) sodium-glucose co-transporter inhibitor (SGLTi); scoring is based on drug class- 1 to 4.

Dose of HFrEF core medication classes based on distressed community index (DCI)

DCI score (0-100) comes from a national database that uses zip code to determine community distress (previously described). HFrEF medication "dose" score is based on prescription dose of core 4 classes of medications per the electronic health record: 1) RASi or hydralazine/nitrate if severe chronic kidney disease or other contraindication, 2) eBB or ivabradine if beta blockers are contraindicated), 3) MRA, and 4) SGLTi; scoring has 4 categories: not used, \< 50% target dose, 50-100% target dose and \> 100% target dose per national HFrEF guidelines

Use of HFrEF core medication classes based on social vulnerability index (SVI)

SVI score (0-1) comes from a national database that uses zip code to determine social vulnerability (previously described). HFrEF medication "use" score is based on prescription of core 4 classes of medications per the electronic health record: 1) RASi or hydralazine/nitrate if severe chronic kidney disease or other contraindication, 2) eBB or ivabradine if beta blockers are contraindicated, 3) MRA, and 4) SGLTi; scoring is based on drug class- 1 to 4.

Dose of HFrEF core medication classes based on social vulnerability index (SVI)

SVI score (0-1) comes from a national database that uses zip code to determine social vulnerability (previously described). DCI score (0-100) comes from a national database that uses zip code to determine community distress (previously described). HFrEF medication "dose" score is based on prescription dose of core 4 classes of medications per the electronic health record: 1) RASi or hydralazine/nitrate if severe chronic kidney disease or other contraindication, 2) eBB or ivabradine if beta blockers are contraindicated), 3) MRA, and 4) SGLTi; scoring has 4 categories: not used, \< 50% target dose, 50-100% target dose and \> 100% target dose per national HFrEF guidelines.

Optimal cut-point of NTproBNP for diagnosis of HF in primary care patients meeting study inclusion criteria

In adults who meet inclusion/exclusion criteria for EAGLE-HF and are randomized to the active arm group, NTproBNP mean (standard deviation) values of those who are diagnosed with HF vs. no HF. In those who meet HF criteria (as previously described), cutoff scores may be generated for HFrEF, HFmrEF and HFpEF.

Optimal cut-point of NTproBNP for diagnosis of HF in primary care patients based on social determinants of health (6 factors)

In adults who meet inclusion/exclusion criteria for EAGLE-HF and are randomized to the active arm group, NTproBNP mean (standard deviation) values of those who are diagnosed with HF vs. no HF based on the 6 factors that make up social determinants of health score. Cut-point scores by social determinants of health may be generated for HFrEF, HFmrEF and HFpEF.

Optimal cut-off point of NTproBNP for diagnosis of heart failure in primary care patients based on the number of risk factors for study inclusion (2 to 8)

In adults who are randomized to the active arm group of EAGLE-HF, assess NTproBNP mean (standard deviation) values of those who are diagnosed with HF vs. no HF based on the 8 risk factors for HF development (all patients will have 2 factors and can have up to 8 factors). Cut-point scores by the number of risk factors may be generated for HFrEF, HFmrEF and HFpEF.

Optimal cut-off point of NTproBNP for diagnosis of heart failure in primary care patients based on the 2 most common risk factors for study inclusion

In adults who are randomized to the active arm group of EAGLE-HF, assess NTproBNP mean (standard deviation) values of those who are diagnosed with HF vs. no HF based on the 2 most common risk factors for HF development. Cut-point scores by the 2 most common risk factors may be generated for HFrEF, HFmrEF and HFpEF.