Aim
This study aims to improve the way patients with chest pain are assessed in Emergency Departments across the United Kingdom. By understanding which approaches are safest and most effective, we hope to reduce unnecessary hospital admissions while ensuring that people experiencing a heart attack receive prompt treatment.
Background
Chest pain is one of the most common reasons people attend Emergency Departments, with more than one million visits every year across the UK. Although chest pain can be a sign of a heart attack, most people who attend hospital with chest pain are not having one.
Doctors use blood tests, including cardiac troponin tests that look for signs of damage to the heart, to help decide whether a heart attack can be ruled out. Different hospitals use different assessment pathways, with variations in when blood samples are taken and the test results used to make decisions.
Understanding which pathways work best could help patients receive reassurance and treatment more quickly, reduce time spent in hospital, and make better use of NHS resources.
Research
Previous studies suggest that using effective early rule-out pathways could prevent up to 250,000 hospital admissions each year across the UK. However, we do not yet know how well these pathways perform in everyday clinical practice or whether outcomes vary between different groups of patients.
This project will use routinely collected healthcare data to evaluate the safety and effectiveness of these pathways across the UK. The research will explore differences in outcomes between regions and patient groups, helping to identify opportunities to improve care and reduce inequalities.
The project will also help create the data systems needed to support future research into new diagnostic technologies, including rapid bedside testing and artificial intelligence tools that could assist clinical decision-making.
Patient and Public Involvement
Patients and members of the public have helped shape this research from the outset. Feedback has been gathered from people with experience of heart disease and from patients who have attended hospital with suspected heart problems.
Their responses have been positive and supportive, highlighting the importance of improving the assessment of chest pain in Emergency Departments. A group of patients and carers will continue to work alongside the research team, helping to guide the project and share the findings with patients, healthcare professionals and the wider public.
Approval
This project was unanimously supported by the PIONEER Data Trust Committee.
Project Lead
Dr Vinay Reddy-Kolanu, Consultant Physician in Acute Medicine, University Hospitals Birmingham NHS Foundation Trust
