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Trial registered on ANZCTR
Registration number
ACTRN12611000470998
Ethics application status
Approved
Date submitted
1/05/2011
Date registered
6/05/2011
Date last updated
6/05/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Streamlining follow up of intermediate risk chest pain presentations: Does pre-organised early stress testing improve compliance to guidelines and 30-day outcomes?
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Scientific title
In patients discharged from the emergency department with intermediate risk acute coronary syndrome, does pre-organised appointments for early stress testing improve compliance with current guidelines and 30 day outcomes compared with patients who were asked to organise their own appointments.
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Secondary ID [1]
260085
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
Nil
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intermediate risk of non-ST-elevation acute coronary syndrome
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Condition category
Condition code
Cardiovascular
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0
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Coronary heart disease
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Public Health
265952
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0
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Health promotion/education
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Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Evaluating the rate of attendance for follow up exercise stress testing in patients who were given pre-organised appointment times.
Evaluating the representation rate with cardiac related chest pain, adverse cardiac events, coronary intervention procedures and mortality over 30 days following their discharge.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
Historical control group: this group of patients are patients who have been discharged with the same inclusion criteria as the experimental group but were not given pre-organised appointment times. Rather they were asked to make their own appointment or contact their general practitioner for a referral for exercise stress testing. The control group have been selected from patients meeting the inclusion criteria between January 2010 to June 2010 from the same hospital (Armadale Health Services)
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Control group
Historical
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Outcomes
Primary outcome [1]
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To determine whether providing patients with pre-organised appointment times increases their compliance to return for exercise stress testing.
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Assessment method [1]
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Timepoint [1]
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Follow up will occur at day 30 post discharge from the emergency department in order to evaluate their compliance with attending exercise stress testing
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Secondary outcome [1]
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To determine the 30 day mortality rate of patients discharged with a diagnosis of intermediate risk ACS.
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Assessment method [1]
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Timepoint [1]
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Day 30 post discharge from the emergency department
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Secondary outcome [2]
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To determine the likelihood of major adverse cardiac events in patient who returned for EST compared to those who did not.
Major adverse cardiac events include ST-elevation myocardial infarcts, angioplasty/stent, Coronary Artery Bypass Grafting (CABG), stable and unstable angina.
This outcome will be assessed by collecting data from health department databases and software and performing telephone interviews with patients.
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Assessment method [2]
276165
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Timepoint [2]
276165
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Day 30 post discharge from the emergency department
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Secondary outcome [3]
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To determine what barriers prevent patients from attending follow up EST.
This outcome will be assessed with telephone interviews and questionnaire.
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Assessment method [3]
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Timepoint [3]
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Day 30 post discharge from the emergency department
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Secondary outcome [4]
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To determine the patients' perceived risk of future cardiac events compared to their actual risk determined by the guidelines set out by the National Heart Foundation/Cardiac Society of Australia and New Zealand.
The patient will be asked to perform a questionnaire over the telephone that will address their perceived risk on an alphabetical scale. (ie A) 1-2%, B) 3-4% etc)
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Assessment method [4]
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Timepoint [4]
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Day 30 post discharge from the emergency department
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Eligibility
Key inclusion criteria
>18 yo and informed consent obtained, discharged from emergency department with intermediate risk acute coronary syndrome, suitable for exercise threadmill stress testing, able to follow up patient via telephone at 30 days.
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Pregnancy, contraindications to stress testing, <18 yo or >75 yo, cognitively impaired, inability to consent, inability to follow up patient (overseas visitor or no telephone access)
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Convenience sample
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Timing
Both
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
5/05/2011
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
120
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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Nil
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Address [1]
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Nil
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Country [1]
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Primary sponsor type
Individual
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Name
A/Prof David Playford
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Address
Suite 10, Armadale Hospital Specialist Centre,
3056 Albany Hwy, Armadale
Western Australia 6112
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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Nil
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Country [1]
264074
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Metropolitan Area Health Services
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Ethics committee address [1]
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Fremantle Hospital GPO Box 480 Fremantle, WA 6959
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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01/04/2011
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Approval date [1]
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18/04/2011
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Ethics approval number [1]
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11/76
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Summary
Brief summary
Patients with chest pain presenting to the emergency department are stratified according to likelihood that the pain is due to a heart attack. “Intermediate risk” chest pain may be cardiac in origin but is not due to a heart attack, and requires further follow up. According to current Australian guidelines, these patients should be referred for an exercise stress test within 72 hrs to further clarify their risk. Currently only 30% of patients with intermediate risk chest pain present for their stress test within 72 hours even if stress testing services are readily available on site. We are investigating whether a fixed appointment time given to the patient before they leave the ED results in an improved follow up rate and improved 1 month outcome.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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KEVIN CHUNG
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Address
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The University of Notre Dame
School of Medicine, Fremantle
PO Box 1225
FREMANTLE
WESTERN AUSTRALIA 6959
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Country
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Australia
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Phone
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+61(0)401137838
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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KEVIN CHUNG
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Address
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The University of Notre Dame
School of Medicine, Fremantle
PO Box 1225
FREMANTLE
WESTERN AUSTRALIA 6959
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Country
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Australia
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Phone
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+61(0)401137838
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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