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-cTn EDACS-ADP: EDACS score (<20 or ≥ 21) + hs-TnI at 0, 2, and 6h + ECG + clinical assessment
hs-cTn COVID-ADP: EDACS score (< 16 or ≥ 16) + hs-TnI at 0, 2h + ECG + clinical assessment

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
ContinuousED Visit durationLOS (Length of stay in hours)
  • The target group of those discharged from ED
  • all patients with a troponin test in the ED
  • ED visit (h)
CategoricalED Visit durationStay < 2 hours, discharged within 2h
  • All Participants
  • < 2 (h)
CategoricalED Visit durationStay < 3 hours, discharged within 3
  • All Participants
  • < 3 (h)
CategoricalMI, anyWithin 7 days of first presentation
  • COVID ADP
  • 7 (d)
CategoricalReturn to ED or hospitalPatients presented 5 days later with more chest pain and an initial troponin concentration of 15 ng/L which rose to 21 ng/L
  • All Participants
  • 7 (d)
CategoricalHospitalizationThe rate of Unspecified or Other chest pain admissions to Chest Pain presentations
  • All Participants
  • ED visit

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.
ED Visit duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
ED Visit duration
Universal
Other
Other reference
MI, any
Universal
Other
Other reference
Return to ED or hospital
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
2. MACE components
If a checked component has an asterisk (*), confirm with team before extracting the MACE outcome
ED Visit duration
ED Visit duration
ED Visit duration
MI, any
Return to ED or hospital
Hospitalization

Results

Categorical


ED Visit duration (Stay < 2 hours, discharged within 2h)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
< 2 (h)
95% CI low
Increase%
95% CI high
Reduction%
Total (N analyzed)
Events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.

ED Visit duration (Stay < 3 hours, discharged within 3)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn ( EDACS-ADP:...)
vs.
hs-cTn ( COVID-ADP:...)
< 3 (h)
95% CI low
Increase%
95% CI high
Reduction%
Total (N analyzed)
Events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn ( EDACS-ADP:...)
vs.
hs-cTn ( COVID-ADP:...)

MI, any (Within 7 days of first presentation)

COVID ADP
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
7 (d)
95% CI low
Increase
95% CI high
Increase%
Total (N analyzed)
Reduction%
Events
Odds Ratio (OR)
Percentage
95% CI low (OR)
Note
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Return to ED or hospital (Patients presented 5 days later with more chest pain and an initial troponin concentration of 15 ng/L which rose to 21 ng/L)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
7 (d)
Total (N analyzed)
Reduction%
Events
Odds Ratio (OR)
Percentage
95% CI low (OR)
Note
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

Hospitalization (The rate of Unspecified or Other chest pain admissions to Chest Pain presentations)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn ( EDACS-ADP:...)
vs.
hs-cTn ( COVID-ADP:...)
ED visit
Total (N analyzed)
Reduction%
Events
Percentage
Note
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn ( EDACS-ADP:...)
vs.
hs-cTn ( COVID-ADP:...)

Continuous


ED Visit duration (LOS (Length of stay in hours))

The target group of those discharged from ED
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit (h)
Total (N analyzed)
p value
Mean
Mean Difference (MD)
Median
95% CI low (MD)
25th percentile
95% CI high (MD)
75th percentile
SD (MD)
p value (MD)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
all patients with a troponin test in the ED
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
ED visit (h)
Total (N analyzed)
p value
Median
Mean Difference (MD)
25th percentile
95% CI low (MD)
75th percentile
95% CI high (MD)
SD (MD)
p value (MD)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn

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