ArticleJMIR research protocols2016
HEART Pathway Accelerated Diagnostic Protocol Implementation: Prospective Pre-Post Interrupted Time Series Design and Methods.
Article in JMIR research protocols, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 18 papers.
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.
The HEART Pathway: Bridging the Gap Between Operations, Research, and Education
HRV Guided Accelerated Diagnostic Protocol for Chest Pain Patients - Randomised Control Trial (HRV-ADP RCT)
Who cites it
18 citing papers in PubMed, 31 citations in OpenAlex.
- The High-Sensitivity HEART Pathway Safely Reduces Hospitalizations Regardless of Sex or Race in a Multisite Prospective US Cohort.Clinical cardiology · 2024Article
- Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome.Circulation. Cardiovascular quality and outcomes · 2024Article
- Rural and socioeconomic differences in the effectiveness of the HEART Pathway accelerated diagnostic protocol.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2023Article
- Age differences in the safety and effectiveness of the HEART Pathway accelerated diagnostic protocol for acute chest pain.Journal of the American Geriatrics Society · 2022Article
- Major adverse cardiac event rates in moderate-risk patients: Does prior coronary disease matter?Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2022Article
- A retrospective HEART risk score comparation of acute non-traumatic chest pain patients in an emergency department in Spain.Scientific reports · 2021Observational
- Sex and race differences in safety and effectiveness of the HEART pathway accelerated diagnostic protocol for acute chest pain.American heart journal · 2021Article
- Identification of very low-risk acute chest pain patients without troponin testing.Emergency medicine journal : EMJ · 2020Article
- HEART Pathway Implementation Safely Reduces Hospitalizations at One Year in Patients With Acute Chest Pain.Annals of emergency medicine · 2020Article
- Comparison of accelerated diagnostic pathways for acute chest pain risk stratification.Heart (British Cardiac Society) · 2020Article
- Safely Identifying Emergency Department Patients With Acute Chest Pain for Early Discharge.Circulation · 2018Article
- Novel Method to Efficiently Create an mHealth App: Implementation of a Real-Time Electrocardiogram R Peak Detector.JMIR mHealth and uHealth · 2018Article
- 3 for the Price of 1: Teaching Chest Pain Risk Stratification in a Multidisciplinary, Problem-based Learning Workshop.The western journal of emergency medicine · 2018Article
- Utilizing PDSA Cycle in Implementing a Chest Pain Accelerated Diagnostic Protocol.Spartan medical research journal · 2017Article
- Chest pain triage: Current trends in the emergency departments in the United States.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Review
- The HEART Pathway and Hospital Cost Savings.Critical pathways in cardiology · 2017Article
- Syncope Risk Stratification in the Emergency Department: Another Step Forward.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- Web Health Monitoring Survey: A New Approach to Enhance the Effectiveness of Telemedicine Systems.JMIR research protocols · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundMost patients presenting to US Emergency Departments (ED) with chest pain are hospitalized for comprehensive testing. These evaluations cost the US health system >$10 billion annually, but have a diagnostic yield for acute coronary syndrome (ACS) of <10%. The history/ECG/age/risk factors/troponin (HEART) Pathway is an accelerated diagnostic protocol (ADP), designed to improve care for patients with acute chest pain by identifying patients for early ED discharge. Prior efficacy studies demonstrate that the HEART Pathway safely reduces cardiac testing, while maintaining an acceptably low adverse event rate.
objectiveThe purpose of this study is to determine the effectiveness of HEART Pathway ADP implementation within a health system.
methodsThis controlled before-after study will accrue adult patients with acute chest pain, but without ST-segment elevation myocardial infarction on electrocardiogram for two years and is expected to include approximately 10,000 patients. Outcomes measures include hospitalization rate, objective cardiac testing rates (stress testing and angiography), length of stay, and rates of recurrent cardiac care for participants.
resultsIn pilot data, the HEART Pathway decreased hospitalizations by 21%, decreased hospital length (median of 12 hour reduction), without increasing adverse events or recurrent care. At the writing of this paper, data has been collected on >5000 patient encounters. The HEART Pathway has been fully integrated into health system electronic medical records, providing real-time decision support to our providers.
conclusionsWe hypothesize that the HEART Pathway will safely reduce healthcare utilization. This study could provide a model for delivering high-value care to the 8-10 million US ED patients with acute chest pain each year. CLINICALTRIAL: Clinicaltrials.gov NCT02056964; https://clinicaltrials.gov/ct2/show/NCT02056964 (Archived by WebCite at http://www.webcitation.org/6ccajsgyu).
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What OpenQuestion holds
Registered trials
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.