Artificial Intelligence (AI), Cost-effectiveness Analysis, Electrocardiogram, OMI - Occlusion Myocardial Infarction
Conditions
Brief summary
This trial will prospectively evaluate the impact of integrating AI-ECG within the pay-for-performance program on improving the diagnosis, treatment, and clinical outcomes of occlusion myocardial infarction patients by promoting accurate and timely diagnoses through financial incentives.
Detailed description
The investigators have developed an AI-ECG system that provides real-time notifications for patients with potential occlusion myocardial infarction. This AI algorithm is seamlessly integrated into the Hospital Information System, allowing for the automatic generation of reports whenever an ECG is performed. The purpose of this study is to evaluate the impact of AI-ECG on the timely diagnosis of STEMI, including patients' outcomes and healthcare costs.
Interventions
OTHERAI-ECG P4P program
The AI-ECG system will conduct a real-time analysis of the ECG. When the system identifies potential OMI cases, it will immediately send short message service notifications to the on-duty cardiologists. This will enable the cardiologists to promptly review and confirm the diagnosis.
Sponsors
National Defense Medical Center, Taiwan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients in the emergency department * Patients received at least 1 ECG examination.
Exclusion criteria
* The patients received ECG at the period of inactive AI-ECG system. * Patients with a history of coronary angiography within the past 3 days.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| D-to-W time (Door to Wire Time) | From the start of the emergency visit to the following 48 hours. | Door-to-wire time refers to the duration from a patient's arrival at the emergency department (ED) to the successful placement of a wire into the coronary artery during a primary percutaneous coronary intervention (PPCI) procedure. |
| Cost Outcome Measure | From the start of the emergency visit to 90 days post-discharge. | Total expenditures, from the start of the emergency visit to 90 days post-discharge (in USD), for comparison between the intervention and control groups, based on records from NHI (National Health Insurance) claims data. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Door-to-Wire time less than 90 minutes | 48 hours | The proportion of patients achieving a Door-to-Wire time of less than 90 minutes in the intervention group compared to the control group. The intervention and control groups' door-to-wire time will be compared. Door-to-wire time is defined as the duration from the first ECG to the successful placement of the wire during PPCI for OMI patients in the emergent department. |
| In-hospital all-cause Mortality Rate | 90-day follow | The proportion of patients who die from any cause, regardless of the underlying condition, during hospitalization. |
| In-hospital cardiac death | 90-day follow | The proportion of patients who die from cardiovascular-related causes during hospitalization. |
| Length of ICU | 90-day follow | Comparison of length of ICU between the intervention and control groups. |
| Length of hospitalization | 90-day follow | Comparison of length of hospitalization between the intervention and control groups. |
| Cardiovascular events | 90-day follow | Composite cardiovascular events (Non-fatal MI + Non-fatal stroke + CV Death) The rate of composite cardiovascular events within 90 days. |
| Non-fatal MI | 90-day follow | The rate of non-fatal MI within 90-days. |
| Non-fatal stroke (Ischemic stroke + Hemorrhagic stroke) | 90-day follow | The rate of non-fatal strokes (both ischemic and hemorrhagic) within 90-days. |
| Cardiac Death | 90-day follow | The proportion of patients who die from cardiovascular-related causes within 90-days. |
| Ischemic stroke | 90-day follow | The incidence of ischemic stroke. |
| Hemorrhagic stroke | 90-day follow | The incidence of hemorrhagic stroke. |
| All-cause mortality | 90-day follow | The proportion of patients who die from any cause within 90-days. |
| Coronary artery bypass grafting (CABG) | 90-day follow | The rate of patients who undergo coronary artery bypass surgery (CABG) within 90-days following OMI treatment. |
| Heart failure admission | 90-day follow | The rate of hospital admissions for heart failure within 90-days following OMI treatment. |
| Re-hospitalization (from any cause) | 90-day follow | The rate of readmission to the hospital within 90-days of discharge. |
Countries
Taiwan
Contacts
CONTACTChin Lin, PhD
PRINCIPAL_INVESTIGATORChin Lin, PhD
National Defense Medical Center
Outcome results
None listed