|PRE-HOSPITAL EVALUATION OF SENSITIVE TROPONIN (PRESTO) STUDY
|National Institute for Health Research for Patient Benefit (NIHR RFBP) Programme
|Our primary aim is to determine whether paramedics can accurately use a simple algorithm and a near-patient blood test to avoid unnecessarily transporting patients with suspected acute coronary syndromes to hospital Emergency Departments for further tests.
|Primary objective is to evaluate diagnostic accuracy of the T-MACS decision aid when applied by paramedics in the prehospital setting using portable near-patient (point of care) cardiac troponin tests.
Secondary objectives are to evaluate the projected impact of implementing this intervention on the following outcomes:
|Prospective, observational diagnostic accuracy study
|The primary outcome will be the diagnosis of ACS, which will be adjudicated by two independent investigators blinded to the assessment of T-MACS by paramedics. Discrepancies will be resolved by a third independent investigator. ACS will be defined as either (a) prevalent acute myocardial infarction (AMI), defined in accordance with the universal definition of AMI; or (b) incident major adverse cardiac events (cardiac death, AMI or non-elective coronary revascularization) within 30 days. Secondary outcomes will include healthcare resource utilisation and health status (EQ-5D).
|Peer reviewed publications and conference presentations.
|This study will identify a novel means of delivering efficient pre-hospital emergency care to patients with chest pain. With a programme of training and dissemination and based on similar precedents, we aim to achieve clinical implementation within 2 years. This is likely to lead to substantial cost savings for the NHS and safe early reassurance for thousands of patients.