Evidence map›Paper›PMID 28082714›Full record

ArticleCirculation. Cardiovascular interventions2017

Association of Rapid Care Process Implementation on Reperfusion Times Across Multiple ST-Segment-Elevation Myocardial Infarction Networks.

Christopher B Fordyce, Hussein R Al-Khalidi, James G Jollis, Mayme L Roettig, Joan Gu, Akshay Bagai, Peter B Berger, Claire C Corbett, Harold L Dauerman, Kathleen Fox and 7 more

Registry-linked trialAbstract readEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Cardiovascular interventions, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04381260 (RUral dispaRities in prehospitAL STEMI), which is not on this map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04381260 completednot on this mapstarted 2020, after this paper: background citation

RUral dispaRities in prehospitAL STEMI

Typeobservational_patient_registrySponsorWake Forest University Health SciencesRan2020 to 2022Enrolled473ConditionsST Elevation Myocardial Infarction, Cardiovascular DiseasesArmsNo intervention, Interview, Survey
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
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  4. Observational
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  8. Rural EMS STEMI Patients - Why the Delay to PCI?Prehospital emergency care · 2024
    Article
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  11. Interhospital Transfer versus Direct Admission in Patients with Acute ST-Segment Elevation Myocardial Infarction.The International journal of angiology : official publication of the International College of Angiology, Inc · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Christopher B FordyceFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.). christopher.fordyce@duke.edu.
Hussein R Al-KhalidiFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
James G JollisFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Mayme L RoettigFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Joan GuFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Akshay BagaiFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Peter B BergerFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Claire C CorbettFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Harold L DauermanFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Kathleen FoxFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
J Lee GarveyFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Timothy D HenryFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Ivan C RokosFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Matthew W SherwoodFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
B Hadley WilsonFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
Christopher B GrangerFrom the Division of Cardiology, University of British Columbia, Vancouver, Canada (C.B.F.); Duke Clinical Research Institute, Durham, NC (C.B.F., H.R.A.-K., M.L.R., J.G., K.F., M.W.S., C.B.G.); University of North Carolina, Chapel Hill (J.G.J.); St. Michael's Hospital, University of Toronto, ON, Canada (A.B.); Northwell Health, Great Neck, NY (P.B.B.); New Hanover Regional Medical Center, Wilmington, NC (C.C.C.); University of Vermont College of Medicine, Burlington (H.L.D.); Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC (J.L.G.); Cedars-Sinai Heart Institute, Los Angeles, CA (T.D.H.); UCLA-Olive View Medical Center, Los Angeles, CA (I.C.R.); and Sanger Heart & Vascular Institute, Carolinas Medical Center, Charlotte, NC (B.H.W.).
STEMI Systems Accelerator Project

Funding

MULTIDISCIPLINARY HEART &VASCULAR DISEASEST32HL007101 · NHLBI · DUKE UNIVERSITY · PI FREEDMAN, NEIL J. · 1985 to 2020
$9.8M
NHLBI NIH HHS T32 HL007101
6 · The paper itself

Abstract

backgroundThe Mission: Lifeline STEMI Systems Accelerator program, implemented in 16 US metropolitan regions, resulted in more patients receiving timely reperfusion. We assessed whether implementing key care processes was associated with system performance improvement. METHODS AND

resultsHospitals (n=167 with 23 498 ST-segment-elevation myocardial infarction patients) were surveyed before (March 2012) and after (July 2014) program intervention. Data were merged with patient-level clinical data over the same period. For reperfusion, hospitals were grouped by whether a specific process of care was implemented, preexisting, or never implemented. Uptake of 4 key care processes increased after intervention: prehospital catheterization laboratory activation (62%-91%; P<0.001), single call transfer protocol from an outside facility (45%-70%; P<0.001), and emergency department bypass for emergency medical services direct presenters (48%-59%; P=0.002) and transfers (56%-79%; P=0.001). There were significant differences in median first medical contact-to-device times among groups implementing prehospital activation (88 minutes implementers versus 89 minutes preexisting versus 98 minutes nonimplementers; P<0.001 for comparisons). Similarly, patients treated at hospitals implementing single call transfer protocols had shorter median first medical contact-to-device times (112 versus 128 versus 152 minutes; P<0.001). Emergency department bypass was also associated with shorter median first medical contact-to-device times for emergency medical services direct presenters (84 versus 88 versus 94 minutes; P<0.001) and transfers (123 versus 127 versus 167 minutes; P<0.001).

conclusionsThe Accelerator program increased uptake of key care processes, which were associated with improved system performance. These findings support efforts to implement regional ST-segment-elevation myocardial infarction networks focused on prehospital catheterization laboratory activation, single call transfer protocols, and emergency department bypass.

Indexed as

Cardiac CatheterizationCardiology Service, HospitalCritical PathwaysDelivery of Health Care, IntegratedEmergency Medical ServicesEmergency Service, HospitalHospital MortalityHumansMyocardial ReperfusionPatient TransferProcess Assessment, Health CareProgram EvaluationQuality ImprovementQuality Indicators, Health CareRegistriesST Elevation Myocardial Infarctionpercutaneous coronary interventionquality improvementreperfusion timesST-segment–elevation myocardial infarctionsystems of care

Identifiers

PMID28082714
PMCPMC6561112

What OpenQuestion holds

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Read underepoch 390

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.