Standardizing Emergency Work-ups Around Risk Data

Completed

Conditions studied: Acute Coronary Syndrome, Chest Pain, Risk Reduction

In brief

Chest pain is the second leading reason for emergency department (ED) visits in the United States. Resource utilization for this ED subpopulation is particularly high, in part due to a dearth of accepted standardized clinical approaches and general overestimation of risk on the part of both providers and patients. This prospective observational cohort study seeks to address this issue by providing externally validated risk scores for major adverse cardiac events using a web-based clinical decision support platform (RISTRA) embedded within the electronic health record at 13 Kaiser Permanente Northern California (KPNC) EDs over a 12-month period. The decision support will provide risk estimates specific to the KPNC patient population. This studies hypothesis is that the provision of more accurate risk estimation for major adverse cardiac events will improve informed decision making by both providers and patients, resulting in less provocative testing and lower ED lengths of stay amongst low risk patients, as well as improving medical management among non-low risk patients and decreasing future rates of major adverse cardiac events.

Key facts

Study ID

NCT03286179

Run by

Kaiser Permanente

People needed

13419

Starts

2018-07-01

Expected to finish

2020-06-01

Last updated by the study team

2020-08-12

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: accepted.

You may qualify if…

• Emergency department chief complaint of chest pain or chest discomfort
• Clinical concern for possible cardiac ischemia

Where it is running

• Kaiser Permanente Antioch Emergency Department — Antioch, California, United States
• Kaiser Permanente Fremont Emergency Department — Fremont, California, United States
• Kaiser Permanente Oakland Emergency Department — Oakland, California, United States
• Kaiser Permanente Richmond Emergency Department — Richmond, California, United States
• Kaiser Permanente Roseville Emergency Department — Roseville, California, United States
• Kaiser Permanente South Sacramento Emergency Department — Sacramento, California, United States
• Kaiser Permanente Sacramento Emergency Department — Sacramento, California, United States
• Kaiser Permanente San Francisco Emergency Department — San Francisco, California, United States
• Kaiser Permanente San Leandro Emergency Department — San Leandro, California, United States
• Kaiser Permanente San Rafael Emergency Department — San Rafael, California, United States
• Kaiser Permanente South San Francisco Emergency Department — South San Francisco, California, United States
• Kaiser Permanente Walnut Creek Emergency Department — Walnut Creek, California, United States

Full record on ClinicalTrials.gov

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