Evidence map›Paper›PMID 36379587›Full record

ArticleCMAJ open

Cardiac Link: a retrospective cohort study evaluating a clinical pathway for expedited cardiology referral.

Fahmeen J Afgani, Connor T A Brenna, Kate Hanneman, Stephen Holzapfel, Corwin Burton, Paula J Harvey, Elsie T Nguyen

Open access · diamondAbstract read
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 43% of its field
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.

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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

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 at 3 institutions in 1 country.

Fahmeen J AfganiWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Connor T A BrennaWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Kate HannemanWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Stephen HolzapfelWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Corwin BurtonWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Paula J HarveyWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont.
Elsie T NguyenWomen's College Research Institute (Afgani, Holzapfel, Burton, Harvey), Women's College Hospital; Postgraduate Medical Education (Brenna), University of Toronto; Joint Department of Medical Imaging (Hanneman, Burton, Nguyen), Toronto General Hospital; Departments of Medical Imaging (Hanneman, Nguyen), Family and Community Medicine (Holzapfel) and Medicine (Harvey), University of Toronto, Toronto, Ont. elsie.nguyen@uhn.ca.
Women's College Hospital · CAToronto General Hospital · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOutpatients presenting with chest pain often face long wait times for cardiology consultation and subsequent investigation for obstructive coronary artery disease (CAD), during which adverse cardiovascular events may occur. Our objective was to describe the design of Cardiac Link, a coronary computed tomography angiogram (CCTA)-guided rapid-access program, and evaluate its effect on cardiology consultation wait times in patients who present to primary care physicians with stable chest pain.

methodsWe conducted a retrospective cohort study at Women's College Hospital, Toronto, Ontario, Canada, between 2017 and 2020 involving eligible patients from the Family Practice Health Centre who underwent CCTA after presenting with stable chest pain or equivalent symptoms. Referring primary care physicians decided on a patient-by-patient basis to opt into the Cardiac Link program when requesting CCTA. Our primary outcome was measure of time from CCTA to cardiology consultation, and our secondary outcomes were measures of time to diagnosis from primary care consultation and CCTA booking time.

resultsOur analysis included 148 patients (Cardiac Link

interpretationWe determined that the Cardiac Link program reduced cardiology consultation wait times for symptomatic patients who were suspected of having CAD. Our study shows the viability of CCTA-guided rapid-access programs to expedite specialist consultation and reduce unnecessary referral for patients presenting to primary care physicians with stable chest pain.

Indexed as

CardiologyCoronary Artery DiseaseChest PainCritical PathwaysFemaleHumansMaleMiddle AgedOntarioReferral and ConsultationRetrospective Studies

Identifiers

PMID36379587
PMCPMC9671298
OpenAlexW4309048366

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.