Trial reportBMJ (Clinical research ed.)2007
Effectiveness and safety of chest pain assessment to prevent emergency admissions: ESCAPE cluster randomised trial.
Trial report in BMJ (Clinical research ed.), 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00869245 (Efficacy Evaluation of Observation Unit Cardiac Magnetic Resonance Imaging), which is not on this map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Efficacy Evaluation of Observation Unit Cardiac Magnetic Resonance Imaging (MRI) in Patients With Intermediate Risk Acute Chest Pain
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Hospitalisation in short-stay units for adults with internal medicine diseases and conditions.The Cochrane database of systematic reviews · 2018Pooled it
- Trial
- Nonspecific chest pain and hospital revisits within 7 days of care: variation across emergency department, observation and inpatient visits.BMC health services research · 2020Article
- Value of early rest myocardial perfusion imaging with SPECT in patients with chest pain and non-diagnostic ECG in emergency department.The international journal of cardiovascular imaging · 2019Article
- [Chest pain units or chest pain algorithm?].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014Review
- Noncardiac chest pain in a patient with cardiac pathology: the importance of an accurate history.JRSM open · 2014Article
- Cost burden of non-specific chest pain admissions.Irish journal of medical science · 2013Article
- Cost effectiveness of chest pain unit care in the NHS.BMC health services research · 2008Article
- Effectiveness of chest pain units.BMJ (Clinical research ed.) · 2007Article
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether introducing chest pain unit care reduces emergency admissions without increasing reattendances and admissions over the next 30 days.
designCluster randomised before and after intervention trial.
setting14 diverse acute hospitals in the United Kingdom.
participantsPatients attending the emergency department with acute chest pain during the year before and the year after the intervention started.
interventionEstablishment of chest pain unit care compared with continuation of routine care.
main outcome measuresProportion of chest pain attendances resulting in admission; reattendances and admissions over the next 30 days; daily emergency medical admissions (all causes); and proportion of emergency department attendances with chest pain.
resultsThe introduction of chest pain unit care was associated with weak evidence of an increase in emergency department attendances with chest pain (16% v 3.5%; P=0.08); no change in the proportion of chest pain attendances resulting in admission (odds ratio 0.998, 95% confidence interval 0.940 to 1.059; P=0.945); small increases in the proportion reattending (odds ratio 1.10, 1.00 to 1.21; P=0.036) or being admitted (1.30, 0.97 to 1.74; P=0.083) over the next 30 days; and evidence of increased daily medical admissions (1.7 per day, 95% confidence interval 0.8 to 2.5; P<0.001). However, this last finding was highly sensitive to changes in the method used to handle missing data.
conclusionThe introduction of chest pain unit care did not reduce the proportion of patients with chest pain admitted and may have been associated with increased emergency department attendances with chest pain.
trial registrationCurrent Controlled Trials ISRCTN55318418.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.