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#PCORI2018
Emergency care For you, or with you?
Erik P. Hess MD MSc
Professor of Emergency Medicine University of Alabama at Birmingham @ErikHessMD October 31, 2018
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COI Disclosures
Erik P. Hess MD MSc
- Nothing to disclose
Emergency care For you, or with you? Erik P. Hess MD MSc Professor - - PowerPoint PPT Presentation
Emergency care For you, or with you? Erik P. Hess MD MSc Professor - - PowerPoint PPT Presentation
Emergency care For you, or with you? Erik P. Hess MD MSc Professor of Emergency Medicine University of Alabama at Birmingham @ErikHessMD October 31, 2018 #PCORI2018 COI Disclosures Erik P. Hess MD MSc Nothing to disclose 2 3 Does the
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Does the tool work?
A multicenter randomized trial
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How would you get in the study?
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Who was included?
- Primary complaint of chest pain
- Being considered for hospital admission for cardiac stress testing
- Not included: ischemic ECG, elevated troponin, known coronary
artery disease, recent cocaine use
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What outcomes did we measure?
- Patient-centered: knowledge, engagement, acceptability
- Clinical endpoints
- Safety: Major Adverse Cardiac Events
- Resource use: Rates of hospital admission and stress testing
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What did we find? (n=898)
Outcome Change Patient knowledge
↑
Patient engagement
↑
Admitted for stress testing
↓ (16%)
Stress testing within 30 days
↓ (8%)
Provider experience
↑
Outpatient follow-up
↑
Safety
↔
Hess, Montori et al. BMJ 2016
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Limitations and Next Steps
- Limited power to definitively demonstrate safety
- Effectiveness outside randomized trial unknown
- Next step: Dissemination and Implementation
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