ArticleThe American journal of emergency medicine2017
Cost analysis of the History, ECG, Age, Risk factors, and initial Troponin (HEART) Pathway randomized control trial.
Article in The American journal of emergency medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Referral decisions based on a pre-hospital HEART score in suspected non-ST-elevation acute coronary syndrome: final results of the FamouS Triage study.European heart journal. Acute cardiovascular care · 2022Trial
- The HEART Pathway Randomized Controlled Trial One-year Outcomes.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2019Trial
- Noninvasive Cardiac Testing vs Clinical Evaluation Alone in Acute Chest Pain: A Secondary Analysis of the ROMICAT-II Randomized Clinical Trial.JAMA internal medicine · 2018Trial
- [Advances in the application of the HEART score in patients with acute coronary syndromes].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Review
- Simulated evaluation of large language model stepwise diagnostic reasoning with real-world chest pain encounters and Bayesian networks.BMC medical informatics and decision making · 2026Article
- Characterizing pre-discharge interventions to reduce length of stay for older adults: A scoping review.PloS one · 2025Article
- HEART Score Agreement Between Attending and Resident Emergency Medicine Physicians for Patients With Potential Acute Coronary Syndrome.Ochsner journal · 2025Article
- Use of downstream stress imaging tests for risk stratification of patients presenting to the emergency department with chest pain and low HEART score.Open heart · 2024Article
- Deep learning augmented ECG analysis to identify biomarker-defined myocardial injury.Scientific reports · 2023Article
- 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
- A Machine Learning-Based Applied Prediction Model for Identification of Acute Coronary Syndrome (ACS) Outcomes and Mortality in Patients during the Hospital Stay.Sensors (Basel, Switzerland) · 2023Article
- Electrophysiology practice in low- and middle-income countries: An updated review on access to care and health delivery.Heart rhythm O2 · 2023Review
- Exosomal Composition, Biogenesis and Profiling Using Point-of-Care Diagnostics-Implications for Cardiovascular Disease.Frontiers in cell and developmental biology · 2022Review
- Practice and Evaluation of a Protocol for Collating Information Related to the Emergency Clinical Pathway for Patients With Acute ST-Segment Elevation Myocardial Infarction.Frontiers in cardiovascular medicine · 2022Article
- Scoring systems for the triage and assessment of short-term cardiovascular risk in patients with acute chest pain.Reviews in cardiovascular medicine · 2021Review
- Graded Coronary Risk Stratification for Emergency Department Patients With Chest Pain: A Controlled Cohort Study.Journal of the American Heart Association · 2021Article
- Three Cases of Emergency Department Medical Malpractice Involving "Consultations": How Is Liability Legally Determined?Clinical practice and cases in emergency medicine · 2021Article
- Sex and race differences in safety and effectiveness of the HEART pathway accelerated diagnostic protocol for acute chest pain.American heart journal · 2021Article
- HEART Pathway Implementation Safely Reduces Hospitalizations at One Year in Patients With Acute Chest Pain.Annals of emergency medicine · 2020Article
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
introductionThe HEART Pathway is a diagnostic protocol designed to identify low-risk patients presenting to the emergency department with chest pain that are safe for early discharge. This protocol has been shown to significantly decrease health care resource utilization compared with usual care. However, the impact of the HEART Pathway on the cost of care has yet to be reported. METHODS AND
resultsWe performed a cost analysis of patients enrolled in the HEART Pathway trial, which randomized participants to either usual care or the HEART Pathway protocol. For low-risk patients, the HEART Pathway recommended early discharge from the emergency department without further testing. We compared index visit cost, cost at 30 days, and cardiac-related health care cost at 30 days between the 2 treatment arms. Costs for each patient included facility and professional costs. Cost at 30 days included total inpatient and outpatient costs, including the index encounter, regardless of etiology. Cardiac-related health care cost at 30 days included the index encounter and costs adjudicated to be cardiac-related within that period. Two hundred seventy of the 282 patients enrolled in the trial had cost data available for analysis. There was a significant reduction in cost for the HEART Pathway group at 30 days (median cost savings of $216 per individual), which was most evident in low-risk (Thrombolysis In Myocardial Infarction score of 0-1) patients (median savings of $253 per patient) and driven primarily by lower cardiac diagnostic costs in the HEART Pathway group.
conclusionsUsing the HEART Pathway as a decision aid for patients with undifferentiated chest pain resulted in significant cost savings.
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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.