SPC365

ATLAS: interactive visualisation of real-world data (RWD) to improve Heart Failure management and patient outcomes in Portugal

Session: Sessão de Comunicações Orais 09 – Inteligência Artificial e tomada de decisão no risco cardiovascular e nos sistemas de saúde
Speaker: Ana Leal Neto

Congress: CPC 2026
Topic: N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
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Session Type: Comunicações Orais
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Authors: Ana Leal Neto; Sara Gonçalves; Guilherme Amorim; Rudolfo Mendes Francisco; Marisa Pardal; Francisco Do Carmo; Sofia Sardinha; Daniel Ramos; Rita Canhoto; Ana Catarina Gomes; João Couceiro; Filipa Bernardo

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Background</span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif">: Recent findings from the PORTHOS study&nbsp;indicate an Heart Failure (HF) prevalence of 16.5% among individuals aged &ge;50 years in mainland Portugal, including a high proportion of undiagnosed cases, and important regional heterogeneity. These data stress the need to ensure adequate disease diagnosis and management, and equitable access to high-quality care. Real-world data (RWD) can deliver actionable and timely insights at scale to pinpoint areas with the highest disease burden. Our objective was to create an interactive RWD visualisation tool to describe geographic variation in HF burden across Portugal, enabling targeted interventions to enhance care.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Methods:</span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> We developed ATLAS, an interactive PowerBI dashboard, based upon a retrospective analysis of routinely collected data on admissions and mortality due to heart failure (HF) in Portugal, using hospital production datasets (IQVIA) (Figure 1). We analyzed data from 2018-2023, starting with all 50 public hospitals in mainland Portugal and autonomous regions. Since complete data up to 2023 was only available for 13 units, missing data were&nbsp;imputed using the latest unit-specific figures and trends from similar hospital (based on official ACSS clustering). Relevant admissions were identified using ICD-10 clinical codes for HF (e.g., I50.x) recorded as primary diagnosis. HF prevalence estimates, hospitalisations, and mortality rates were aggregated at national and regional level (NUTS-II).&nbsp;To complement these data, we integrated prevalence estimates from the 2023 PORTHOS population-based study among&nbsp;individuals aged &ge;50 years. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Results:</span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> National HF hospitalisation rates declined over time (1.5% of all admissions in 2018&nbsp;to 1.0% in 2023), with similar trajectories across regions (Figure 2). In 2023, HF hospitalisation rates were 0.9% in Pen&iacute;nsula de Set&uacute;bal and Grande Lisboa, 1.0% in Norte, 1.2% in Centro and Alentejo/Algarve, 1.3% in A&ccedil;ores/Madeira, and 1.4% in Oeste e Vale do Tejo. Contrary to hospitalisation rates, national HF in-hospital mortality increased from 14.0% in 2018 to 14.6% in 2023 (maximum: 15.4% in 2021). Regional HF mortality rates in 2023 were 8.4% in A&ccedil;ores/Madeira, 11.0% in Grande Lisboa, 13.9% in Centro, 14.6% in Norte, 18.0% in Alentejo/Algarve, 18.4% in Oeste e Vale do Tejo, and 19.3% in Pen&iacute;nsula de Set&uacute;bal. Hospitalisation and mortality rates for 2023 showed wide variability across health units nationwide and within regions (e.g. nationwide hospitalisation rates: 0.4%-2.6%,&nbsp;mortality rates: 3.4%-28.8%) - Figure 3.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Aptos,sans-serif"><strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Conclusions:</span></span></strong><span style="font-size:10.5pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> RWD shows longitudinal trajectories of HF burden and outcomes in Portugal at national, regional, and local&nbsp;levels, highlighting&nbsp;important heterogeneity both between and within regions. These data can be leveraged in interactive platforms such as ATLAS to support identification of areas of unmet need, and development of targeted initiatives to improve HF care.</span></span></span></span></p>