Acute Coronary Syndrome
Conditions
Brief summary
We are doing a study to assess the impact of including patients in making decision regarding their own medical care in the emergency department. We will randomly assign them to either receive a decision aid or usual care. In doing this, we aim to increase patient satisfaction and safely decrease medical cost.
Interventions
OTHERDecision Aid
Chest pain choice decision aid
Sponsors
Mayo Clinic
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults with a primary complaint of chest pain. * Treating clinician's next consideration is observation unit admission for cardiac stress testing.
Exclusion criteria
* Initial cardiac troponin T value \>99th percentile (\>0.01ng/mL) * History of coronary artery disease * coronary revascularization procedure within the previous 30 days * cocaine use within 72 hours by the clinician's initial history * pregnancy * patient cannot read English or have, in their clinician's judgment, major learning barriers, such as visual or hearing impairment or dementia that would compromise their ability to give written informed consent (or use the decision aid)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Patient knowledge | Immediately after patient visit | Patient knowledge regarding their short-term risk for an ACS and the risks of radiation exposure. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of decision making process | Immediately after patient visit | Quality of the decision making process for the patient and clinician |
| Satisfaction with decision aid | Immediately after patient visit | Patient and clinician acceptability and satisfaction with the decision aid |
| Proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing | During the initial ED visit | Proportion of patients who decided to undergo observation unit admission and urgent cardiac stress testing |
| Delayed or missed ACS | 30 days | Rate of delayed or missed ACS |
| Economic costs and healthcare utilization | 30 days | Economic costs and healthcare utilization |
Countries
United States
Outcome results
None listed