Extraction form for project: ESP Troponin ADPs

Design Details

1. Cohort name
Cohort, not ADP, name
2. Protocol number (eg, NCT)
3. Copublications
List other records that were extracted with this primary articles. Eg, PMIDs or other identifiers
4. Study design
5. Study years
Just years. Not publication year. Years of study. You may need to estimate. Use tilde (~) if you're approximating. If not reported, put "< ####" (the publication or submission year).
StartEnd
6. Funding
Include provision of materials (eg, cTn labs) from industry as industry funding
7. Country/ies
NR should rarely if ever be selected
8. Setting
9. Centers
If Unclear, add a note why
10. Inclusion criteria
ACS row = Eligibility criteria specific to acute coronary syndrome symptoms/signs. Age/Gender = criteria specific to age/gender. Prior CVD = restriction based on prior cardiovascular disease, event, or procedure. Other = other inclusion criteria. Skip rows that do not pertain. Be concise.
ACS
Age
Gender
Prior CVD
Other
11. Exclusion criteria
Prior CVD = exclusion based on prior cardiovascular disease, event, or procedure. Other = other exclusion criteria. Skip rows that do not pertain. Be concise.
STEMI
Prior CVD
Comorbidity
Other
12. Special/Atypical population
Highlight if this is a specific group of patients. Skip if no particular relevant exclusion criteria
13. Comments/Notes

Arms

Arm NameArm Description
not hs-cTnBefore: Conventional cTn at 6, 12h + (ECG) + history
hs-cTnAfter (Chest pain pathway): Hs-cTnI at 0, 3h + GRACE + TIMI +ECG

Arm Details

1. hs-cTn info
Click NR checkboxes in each row with no reported data
not hs-cTn
DataNR
Test name
Manufacturer
Generation
Limit of detection (ng/L)
Comment/Note
99th %ile
hs-cTn
DataNR
Test name
Manufacturer
Generation
Limit of detection (ng/L)
Comment/Note
99th %ile

Sample Characteristics

1. N Enrolled
2. Age
3. % Male
4. Race/Ethnicity, %
White
White, Non-Hispanic
Black
Hispanic/Latino
Asian (any)
East Asian
South Asian
Other 1
Other 2
Other 3
NR
5. Are there significant differences (statistical or clinical) between the two groups?
6. History of Cardiovascular Disease, %
peripheral arterial disease
Stroke/TIA
Prior MI
prior revascularization (eg., CABG, PCI)
History of Cardiovascular Disease
7. Risk Factors for Cardiovascular Disease, %
Comments
Hypertension
Diabetes
Smoking Histrory
BMI/obesity
Family History
Hyperlipidemia
8. Risk Score
Enter risk score name (eg Heart), mean (SD) or thresholds and proportions
Name Risk ScoreThresholdProportion, %Mean (SD)Comment
Risk Score 1
Risk Score 2
Risk Score 3
Risk Score 4
9. Notes/Comments

Outcomes

TypeDomainSpecific measurement (i.e., tool/definition/specific outcome)PopulationsTimepoints
CategoricalHospitalizationThe proportions of patients requiring admission from the ED
  • All Participants
  • ED visit
CategoricalHospitalizationShort term admissions to the clinical decisions unit
  • All Participants
  • Admitted Patients
  • ED visit
CategoricalHospitalizationAdmission to the medical wards
  • All Participants
  • Among admitted patients
  • ED visit
CategoricalReturn to ED or hospitalReattendance rate following discharge from the ED
  • All Participants
  • 30 (d)
CategoricalReturn to ED or hospitalReattended and required cardiology admission on the second attendance
  • All Participants
  • 30 (d)
CategoricalCardiac testingAngiography
  • All Participants
  • 30 (d)
  • < 72 (h)
  • within 24 h (h)
CategoricalCardiac revascularizationAngioplasty among those who reattended and required cardiology admission on the second attendance
  • reattended and required cardiology admission on the second attendance
  • 30 (d)
ContinuousED Visit durationTime to admission, median hours ± IQR
  • All patients
  • ED visit (h)
ContinuousHospitalization durationThe length of inpatient admission
  • Angiography
  • Patients transferred to cardiology
  • Hospitalization period (d)
ContinuousHospitalization durationInpatient admission, overall median and mean length of stay
  • All Participants
  • Inpatient admission (h)
ContinuousED Visit durationTime to angiography, median hours ± IQR
  • All Participants
  • ED visit (h)
CategoricalHospitalizationCardiology Ward
  • All Participants
  • Among admitted patients
  • ED visit
ContinuousED Visit durationThe median wait in hospital prior to transfer to the cardiology center
  • All Participants
  • ED visit (h)
CategoricalED Visit durationTransfer to a cardiology ward within 12 h of ED attendance
  • Required inpatient cardiology admission
  • Within 12 h of ED visit (h)
CategoricalED Visit durationThe proportion of patients who had angiography performed within 24 hours of arrival to ED
  • All Participants
  • Within 24 h of arrival to ED visit (h)
CategoricalED Visit duration Stay < 4 h (discharged within 4 hours)
  • All Participants
  • Within 4 h of ED visit (h)

Outcome Details

1. MI definition
Universal definitions refer to ESC/ACC/AHA/WHF (or Global MI) task forces. If an Other definition, provide details in 2nd row and the cited reference for their definition in the 3rd row.
Hospitalization
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Return to ED or hospital
Universal
Other
Other reference
Return to ED or hospital
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Cardiac revascularization
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
Hospitalization duration
Universal
Other
Other reference
Hospitalization duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
2. MACE components
If a checked component has an asterisk (*), confirm with team before extracting the MACE outcome
Hospitalization
Hospitalization
Hospitalization
Return to ED or hospital
Return to ED or hospital
Cardiac testing
Cardiac revascularization
ED Visit duration
Hospitalization duration
Hospitalization duration
ED Visit duration
Hospitalization
ED Visit duration
ED Visit duration
ED Visit duration
ED Visit duration

Results

Categorical


Hospitalization (The proportions of patients requiring admission from the ED)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (After (Chest...)
vs.
not hs-cTn (Before:...)
ED visit
Total (N analyzed)
p value
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (After (Chest...)
vs.
not hs-cTn (Before:...)

Hospitalization (Short term admissions to the clinical decisions unit)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
ED visit
Total (N analyzed)
p value
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
Admitted Patients
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Hospitalization (Admission to the medical wards)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
ED visit
Reduction in admission%
p value
Comment
Total (N analyzed)
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
Among admitted patients
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Return to ED or hospital (Reattendance rate following discharge from the ED)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
30 (d)
Reduction in admission%
p value
Comment
Total (N analyzed)
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)

Return to ED or hospital (Reattended and required cardiology admission on the second attendance)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
30 (d)
Reduction in admission%
p value
Comment
Total (N analyzed)
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)

Cardiac testing (Angiography )

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
30 (d)
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
< 72 (h)
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
within 24 h (h)
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Cardiac revascularization (Angioplasty among those who reattended and required cardiology admission on the second attendance)

reattended and required cardiology admission on the second attendance
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
30 (d)
Comment
p value
Total (N analyzed)
Events
No events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.

Hospitalization (Cardiology Ward)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
Among admitted patients
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

ED Visit duration (Transfer to a cardiology ward within 12 h of ED attendance)

Required inpatient cardiology admission
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
Within 12 h of ED visit (h)
Comment
Odds Ratio (OR)
Total (N analyzed)
95% CI low (OR)
Events
95% CI high (OR)
No events
p value
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

ED Visit duration (The proportion of patients who had angiography performed within 24 hours of arrival to ED )

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
Within 24 h of arrival to ED visit (h)
Total (N analyzed)
p value (Median Difference)
No events
Mean Difference (MD)
Percentage
95% CI low (MD)
Note
95% CI high (MD)
SD (MD)
p value (MD)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

ED Visit duration ( Stay < 4 h (discharged within 4 hours))

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
Within 4 h of ED visit (h)
Total (N analyzed)
p value (Median Difference)
Percentage
Mean Difference (MD)
Note
95% CI low (MD)
95% CI high (MD)
SD (MD)
p value (MD)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Continuous


ED Visit duration (Time to admission, median hours ± IQR)

All patients
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit (h)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Median
Mean Difference (MD)
25th percentile
95% CI low (MD)
75th percentile
95% CI high (MD)
Note
SD (MD)
p value (MD)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Hospitalization duration (The length of inpatient admission)

Angiography
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
Hospitalization period (d)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Median
p value (MD)
25th percentile
75th percentile
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.
Patients transferred to cardiology
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
Hospitalization period (d)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Median
25th percentile
75th percentile
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.

Hospitalization duration (Inpatient admission, overall median and mean length of stay)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
Inpatient admission (h)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Mean
p value (MD)
SD
Median
25th percentile
75th percentile
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.

ED Visit duration (Time to angiography, median hours ± IQR)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
ED visit (h)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Median
25th percentile
75th percentile
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)

ED Visit duration (The median wait in hospital prior to transfer to the cardiology center )

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)
ED visit (h)
IQR
p value (Median Difference)
Total (N analyzed)
Comment
Median
p value (MD)
25th percentile
75th percentile
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Before:...)
vs.
hs-cTn (After (Chest...)

Study Risk of Bias

1. Design
2. Clarity: Discrepancies
Was the article free of discrepancies (eg, between text and tables)? Add note if No (High concern)
3. Clarity: Population
Were patient eligibility criteria sufficiently clear? Add note if No (High concern).
4. Clarity: Intervention/Comparator
Were the ADP (and comparator) sufficiently clear? Add note if No (High concern)
5. Clarity: Outcomes
Were outcomes adequately defined without problem? Add note if No (High concern). Not every outcome requires an explicit definition (e.g., duration of ED stay).
6. Clarity: Setting
Was the setting sufficiently clearly defined? (Eg, Do we know the hospital (and ED) type?) Add note if No (High concern).
7. Missing data
Were there missing results data for ANY patients for outcomes that occurred in ED or hospital? Were there missing results data for >20% of patients (or imbalance between study groups) for outcomes that occurred after ED/hospital discharge? Add Note if Yes
8. Outcome ascertainment
9. RCT: Randomization & Allocation Concealment
Was there inadequate randomization method or allocation concealment? Whether randomization was done at the level of the ED or the patient, answer No, unless there's an obvious flaw. If Yes, add note.
10. Observational: Cohort representativeness
Eligible patients having ADP were all selected or a random selection was selected. No concerns about biased selection of ADP patients. Add note if No (high RoB)
11. NRCI: Comparator representativeness
Comparator group (or ED) was sufficiently similar (and selected patients were all included or a random sample were included). Add note if No (high RoB)
12. NRCI: Adjustment for confounders