Measuring outcome differences associated with STEMI screening and diagnostic performance: A multicentred retrospective cohort study protocol

Maame Yaa A.B. Yiadom, Bryn Mumma, Christopher W. Baugh, Brian W. Patterson, Angela M. Mills, Gilberto Salazar, Mary Tanski, Cathy A. Jenkins, Timothy J. Vogus, Karen F. Miller, Brittney E. Jackson, Christoph U. Lehmann, Stephen C. Dorner, Jennifer L. West, Thomas J. Wang, Sean P. Collins, Robert S. Dittus, Gordon R. Bernard, Alan B. Storrow, Dandan Liu

Research output: Contribution to journalArticle

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Abstract

Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known. Methods We present the methods for a retrospective multicentre cohort study anticipated to include 1220 patients across seven EDs to (1) evaluate the relationship between timely screening and diagnosis with treatment and postintervention clinical outcomes; (2) introduce novel measures for cross-facility performance comparisons of screening and diagnostic care team performance including: Door-to-screening, door-to-diagnosis and door-to-catheterisation laboratory arrival times and (3) describe the use of electronic health record data in tandem with an existing disease registry. Ethics and dissemination The completion of this study will provide critical feedback on the quality of screening and diagnostic performance within the contemporary STEMI care pathway that can be used to (1) improve emergency care delivery for patients with STEMI presenting to the ED, (2) present novel metrics for the comparison of screening and diagnostic care and (3) inform the development of screening and diagnostic support tools that could be translated to other care environments. We will disseminate our results via publication and quality performance data sharing with each site. Institutional ethics review approval was received prior to study initiation.

Original languageEnglish (US)
Article numbere022453
JournalBMJ Open
Volume8
Issue number5
DOIs
StatePublished - May 1 2018

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Cohort Studies
Retrospective Studies
Emergency Medical Services
Hospital Emergency Service
Institutional Ethics
Information Dissemination
Electronic Health Records
Ethics
Catheterization
Multicenter Studies
Registries
Publications
Electrocardiography
ST Elevation Myocardial Infarction
Therapeutics

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Measuring outcome differences associated with STEMI screening and diagnostic performance : A multicentred retrospective cohort study protocol. / Yiadom, Maame Yaa A.B.; Mumma, Bryn; Baugh, Christopher W.; Patterson, Brian W.; Mills, Angela M.; Salazar, Gilberto; Tanski, Mary; Jenkins, Cathy A.; Vogus, Timothy J.; Miller, Karen F.; Jackson, Brittney E.; Lehmann, Christoph U.; Dorner, Stephen C.; West, Jennifer L.; Wang, Thomas J.; Collins, Sean P.; Dittus, Robert S.; Bernard, Gordon R.; Storrow, Alan B.; Liu, Dandan.

In: BMJ Open, Vol. 8, No. 5, e022453, 01.05.2018.

Research output: Contribution to journalArticle

Yiadom, MYAB, Mumma, B, Baugh, CW, Patterson, BW, Mills, AM, Salazar, G, Tanski, M, Jenkins, CA, Vogus, TJ, Miller, KF, Jackson, BE, Lehmann, CU, Dorner, SC, West, JL, Wang, TJ, Collins, SP, Dittus, RS, Bernard, GR, Storrow, AB & Liu, D 2018, 'Measuring outcome differences associated with STEMI screening and diagnostic performance: A multicentred retrospective cohort study protocol', BMJ Open, vol. 8, no. 5, e022453. https://doi.org/10.1136/bmjopen-2018-022453
Yiadom, Maame Yaa A.B. ; Mumma, Bryn ; Baugh, Christopher W. ; Patterson, Brian W. ; Mills, Angela M. ; Salazar, Gilberto ; Tanski, Mary ; Jenkins, Cathy A. ; Vogus, Timothy J. ; Miller, Karen F. ; Jackson, Brittney E. ; Lehmann, Christoph U. ; Dorner, Stephen C. ; West, Jennifer L. ; Wang, Thomas J. ; Collins, Sean P. ; Dittus, Robert S. ; Bernard, Gordon R. ; Storrow, Alan B. ; Liu, Dandan. / Measuring outcome differences associated with STEMI screening and diagnostic performance : A multicentred retrospective cohort study protocol. In: BMJ Open. 2018 ; Vol. 8, No. 5.
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abstract = "Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known. Methods We present the methods for a retrospective multicentre cohort study anticipated to include 1220 patients across seven EDs to (1) evaluate the relationship between timely screening and diagnosis with treatment and postintervention clinical outcomes; (2) introduce novel measures for cross-facility performance comparisons of screening and diagnostic care team performance including: Door-to-screening, door-to-diagnosis and door-to-catheterisation laboratory arrival times and (3) describe the use of electronic health record data in tandem with an existing disease registry. Ethics and dissemination The completion of this study will provide critical feedback on the quality of screening and diagnostic performance within the contemporary STEMI care pathway that can be used to (1) improve emergency care delivery for patients with STEMI presenting to the ED, (2) present novel metrics for the comparison of screening and diagnostic care and (3) inform the development of screening and diagnostic support tools that could be translated to other care environments. We will disseminate our results via publication and quality performance data sharing with each site. Institutional ethics review approval was received prior to study initiation.",
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AU - Yiadom, Maame Yaa A.B.

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AU - Baugh, Christopher W.

AU - Patterson, Brian W.

AU - Mills, Angela M.

AU - Salazar, Gilberto

AU - Tanski, Mary

AU - Jenkins, Cathy A.

AU - Vogus, Timothy J.

AU - Miller, Karen F.

AU - Jackson, Brittney E.

AU - Lehmann, Christoph U.

AU - Dorner, Stephen C.

AU - West, Jennifer L.

AU - Wang, Thomas J.

AU - Collins, Sean P.

AU - Dittus, Robert S.

AU - Bernard, Gordon R.

AU - Storrow, Alan B.

AU - Liu, Dandan

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N2 - Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known. Methods We present the methods for a retrospective multicentre cohort study anticipated to include 1220 patients across seven EDs to (1) evaluate the relationship between timely screening and diagnosis with treatment and postintervention clinical outcomes; (2) introduce novel measures for cross-facility performance comparisons of screening and diagnostic care team performance including: Door-to-screening, door-to-diagnosis and door-to-catheterisation laboratory arrival times and (3) describe the use of electronic health record data in tandem with an existing disease registry. Ethics and dissemination The completion of this study will provide critical feedback on the quality of screening and diagnostic performance within the contemporary STEMI care pathway that can be used to (1) improve emergency care delivery for patients with STEMI presenting to the ED, (2) present novel metrics for the comparison of screening and diagnostic care and (3) inform the development of screening and diagnostic support tools that could be translated to other care environments. We will disseminate our results via publication and quality performance data sharing with each site. Institutional ethics review approval was received prior to study initiation.

AB - Introduction Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known. Methods We present the methods for a retrospective multicentre cohort study anticipated to include 1220 patients across seven EDs to (1) evaluate the relationship between timely screening and diagnosis with treatment and postintervention clinical outcomes; (2) introduce novel measures for cross-facility performance comparisons of screening and diagnostic care team performance including: Door-to-screening, door-to-diagnosis and door-to-catheterisation laboratory arrival times and (3) describe the use of electronic health record data in tandem with an existing disease registry. Ethics and dissemination The completion of this study will provide critical feedback on the quality of screening and diagnostic performance within the contemporary STEMI care pathway that can be used to (1) improve emergency care delivery for patients with STEMI presenting to the ED, (2) present novel metrics for the comparison of screening and diagnostic care and (3) inform the development of screening and diagnostic support tools that could be translated to other care environments. We will disseminate our results via publication and quality performance data sharing with each site. Institutional ethics review approval was received prior to study initiation.

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