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-cTnPre-implementation: Single conventional c-cTnI or serial at 0, 3h (6h c-cTnI were not routinely drawn during the c-cTnI period).
hs-cTn Post-implementation: Symptoms duration + hs-TnT at 0, 1, 3h + HEART score

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 durationED LOS (length of stay in minutes) time interval from ED arrival to ED departure. We defined ED arrival time as the time the patient physically arrived in the ED. We defined ED departure as the timewhen the patient physically left the ED. As such, ED LOS for admitted patients included any ED boarding time after admission to the inpatient service.
  • All Participants
  • ED visit (min)
ContinuousED Visit durationBed-to-disposition in minutes (the time interval from placement in an ED treatment room to disposition.)
  • All Participants
  • ED visit (min)
CategoricalHospitalizationObservation only
  • All Participants
  • ED visit
CategoricalHospitalizationObservation to full admission
  • All Participants
  • ED visit
CategoricalHospitalizationFull admission
  • All Participants
  • ED visit
CategoricalCardiac testingPET myocardial scan during the index encounter or within 30 days
  • All Participants
  • 30 (d)
CategoricalHospitalizationCardiology consult or admission Cardiology consultation was defined as a cardiology consult note or admission note signed by an attending cardiologist during the index encounter. Admissions were classified as full admission status, admission to observation status on an inpatient service or chest pain observation service, and initial admission to observation status followed by full admission status.
  • All Participants
  • ED visit
CategoricalHospitalizationNo admission
  • All Participants
  • ED visit
CategoricalCardiac testingCoronary CT angiogram during the index encounter or within 30 days
  • All Participants
  • 30 (d)
CategoricalCardiac testingExercise treadmill stress test during the index encounter or within 30 days
  • All Participants
  • 30 (d)
CategoricalCardiac testingNuclear medicine stress test during the index encounter or within 30 days
  • All Participants
  • 30 (d)
CategoricalCardiac testingCardiac catheterization during the index encounter or within 30 days
  • All Participants
  • 30 (d)
CategoricalCardiac revascularizationCABG surgery during the index encounter or within 30 days of the index presentation
  • All Participants
  • 30 (d)
CategoricalMI, anyNSTEMI
  • All Participants
  • Baseline
CategoricalMI, anySTEMI
  • All Participants
  • ED visit
CategoricalMACEUnstable angina
  • All Participants
  • Baseline
CategoricalMACEUnspecified ACS
  • All Participants
  • Baseline
CategoricalMACEAny ACS diagnosis
  • All Participants
  • Baseline

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
Hospitalization
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Hospitalization
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Cardiac testing
Universal
Other
Other reference
Cardiac revascularization
Universal
Other
Other reference
MI, any
Universal
Other
Other reference
MI, any
Universal
Other
Other reference
MACE
Universal
Other
Other reference
MACE
Universal
Other
Other reference
MACE
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
Hospitalization
Hospitalization
Hospitalization
Cardiac testing
Hospitalization
Hospitalization
Cardiac testing
Cardiac testing
Cardiac testing
Cardiac testing
Cardiac revascularization
MI, any
MI, any
MACE
MACE
MACE

Results

Categorical


Hospitalization (Observation only)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
Odds Ratio, Adjusted (adjOR)
95% CI low (adjOR)
95% CI high (adjOR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Hospitalization (Observation to full admission)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Hospitalization (Full admission)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Cardiac testing (PET myocardial scan during the index encounter or within 30 days)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Hospitalization (Cardiology consult or admission Cardiology consultation was defined as a cardiology consult note or admission note signed by an attending cardiologist during the index encounter. Admissions were classified as full admission status, admission to observation status on an inpatient service or chest pain observation service, and initial admission to observation status followed by full admission status.)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

Hospitalization (No admission)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

Cardiac testing (Coronary CT angiogram during the index encounter or within 30 days)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Cardiac testing (Exercise treadmill stress test during the index encounter or within 30 days)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Cardiac testing (Nuclear medicine stress test during the index encounter or within 30 days)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Cardiac testing (Cardiac catheterization during the index encounter or within 30 days)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

Cardiac revascularization (CABG surgery during the index encounter or within 30 days of the index presentation)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
30 (d)
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

MI, any (NSTEMI)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
Baseline
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

MI, any (STEMI)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
ED visit
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
Odds Ratio, Adjusted (adjOR)
95% CI low (adjOR)
95% CI high (adjOR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

MACE (Unstable angina)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
Baseline
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

MACE (Unspecified ACS)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
Baseline
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

MACE (Any ACS diagnosis)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)
Baseline
Total (N analyzed)
comment
Events
aGMR/aOR
Percentage
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Odds Ratio (OR)
95% CI low (OR)
95% CI high (OR)
p value
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
hs-cTn (...)
vs.
not hs-cTn (Pre-implement...)

Continuous


ED Visit duration (ED LOS (length of stay in minutes) time interval from ED arrival to ED departure. We defined ED arrival time as the time the patient physically arrived in the ED. We defined ED departure as the timewhen the patient physically left the ED. As such, ED LOS for admitted patients included any ED boarding time after admission to the inpatient service.)

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)
ED visit (min)
Total (N analyzed)
aGMR/aOR
Median
95% CI low
25th percentile
95% CI high
75th percentile
95% CI low (Median Difference)
95% CI high (Median Difference)
Comment
95% CI low (aGMR/aOR)
95% CI high (aGMR/aOR)
Median Difference
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
not hs-cTn (Pre-implement...)
vs.
hs-cTn (...)

ED Visit duration (Bed-to-disposition in minutes (the time interval from placement in an ED treatment room to disposition.))

All Participants
Descriptive StatisticsBetween Arm Comparisons
not hs-cTnhs-cTn
vs.
ED visit (min)
Total (N analyzed)
aGMR/aOR
Median
Comment
25th percentile
95% CI low (aGMR/aOR)
75th percentile
95% CI high (aGMR/aOR)
Within Arm ComparisonsNet Comparisons
not hs-cTnhs-cTn
vs.

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