Evidence map›Paper›PMID 30263101›Full record

ArticleHeart international

Calculating the 30-day Survival Rate in Acute Myocardial Infarction: Should we Use the Treatment Chain or the Hospital Catchment Model?

Jan Norum, Tonya M Hansen, Anders Hovland, Lise Balteskard, Bjørn Haug, Frank Olsen, Thor Trovik

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Article in Heart international. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
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2citing papers in PubMed
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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

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Jan NorumDepartment of Surgery, Finnmark Hospital, Hammerfest - Norway.
Tonya M HansenDepartment of Quality and Patient Safety, Norwegian Institute of Public Health, Oslo - Norway.
Anders HovlandDepartment of Clinical Medicine, Faculty of Health Science, UiT - The Arctic University of Norway, Tromsø - Norway.
Lise BalteskardCentre of Clinical Documentation and Evaluation, Northern Norway Regional Health Authority Trust, Tromsø - Norway.
Bjørn HaugDepartment of Medicine, Sandnessjøen Hospital, Sandnessjøen - Norway.
Frank OlsenCentre of Clinical Documentation and Evaluation, Northern Norway Regional Health Authority Trust, Tromsø - Norway.
Thor TrovikDepartment of Cardiology, University Hospital of North-Norway, Tromsø - Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAcute myocardial infarction (AMI) is a potentially deadly disease and significant efforts have been concentrated on improving hospital performance. A 30-day survival rate has become a key quality of care indicator. In Northern Norway, some patients undergoing AMI are directly transferred to the Regional Cardiac Intervention Center at the University Hospital of North Norway in Tromsø. Here, coronary angiography and percutaneous coronary intervention is performed. Consequently, local hospitals may be bypassed in the treatment chain, generating differences in case mix, and making the treatment chain model difficult to interpret. We aimed to compare the treatment chain model with an alternative based on patients' place of living.

methodsBetween 2013 and 2015, a total of 3,155 patients were registered in the Norwegian Patient Registry database. All patients were categorized according to their local hospital's catchment area. The method of Guo-Romano, with an indifference interval of 0.02, was used to test whether a hospital was an outlier or not. We adjusted for age, sex, comorbidity, and number of prior hospitalizations.

conclusionsWe revealed the 30-day AMI survival figure ranging between 88.0% and 93.5% (absolute difference 5.5%) using the hospital catchment method. The treatment chain rate ranged between 86.0% and 94.0% (absolute difference 8.0%). The latter figure is the one published as the National Quality of Care Measure in Norway. Local hospitals may get negative attention even though their catchment area is well served. We recommend the hospital catchment method as the first choice when measuring equality of care.

Indexed as

Myocardial infarctionNorwayQualitySurvival

Identifiers

PMID30263101
PMCPMC6159709

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