A Scenario-based and Modeling Study on the Prevention of Heart Attack in Iran: A Mixed Methods Study Protocol

Background: Globally, cardiovascular disease (CVD) is the number one cause of mortality. Objectives: This study aimed to provide policies for the management of CVD by focusing on the reduction of myocardial infarction (MI) mortality in Iran. Methods: The sequential mixed methods design will be employed to predict the prevalence of MI in Iran in the next 10 years. This study consists of five phases. In the first phase, the risk factors of cardiovascular disease will be investigated using a systematic review. In the second phase, the uncertainty and impact of those factors will be evaluated by the experts. Moreover, the impact/uncertainty grid will be used to identify the most important drivers and critical uncertainties. In the third phase, the cross-impact matrix, the scenario logic and the scenarios will be developed. Once the scenario logic is established, details can be added to the scenarios. The next phase consists of statistical estimations of the rate of mortality due to heart attack using artificial neural networks. Finally, the policies will be developed based on the opinions of the panel of experts. The initial results will be published in mid-2021. Results: This future study will develop policies to prevent from MI with scenario-based and modeling approaches. The findings can benefit healthcare professionals and policymakers by enhancing the management of MI patients. Conclusion: Specific policy recommendations will help policymakers to make evidence-based decisions, re-design structures and processes of healthcare interventions, to decrease the MI mortality.