دورية أكاديمية
أعرض في EDS

Coronary calcium scoring as first-line test to detect and exclude coronary artery disease in patients presenting to the general practitioner with stable chest pain: protocol of the cluster-randomised CONCRETE trial.

التفاصيل البيبلوغرافية
العنوان: Coronary calcium scoring as first-line test to detect and exclude coronary artery disease in patients presenting to the general practitioner with stable chest pain: protocol of the cluster-randomised CONCRETE trial.
المؤلفون: Koopman MY; Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Reijnders JJW; Department of Cardiology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands., Willemsen RTA; Department of Family Medicine, Maastricht University, Maastricht, The Netherlands., van Bruggen R; Multicenter General Practitioners Organisation 'HuisartsenOrganisatie Oost-Gelderland', Apeldoorn, The Netherlands., Doggen CJM; Department of Health Technology & Services Research, Techmed Centre, University of Twente, Enschede, The Netherlands., Kietselaer B; Department of Cardiology, Zuyderland Medical Centre Heerlen, Heerlen, The Netherlands., Oude Wolcherink MJ; Department of Health Technology & Services Research, Techmed Centre, University of Twente, Enschede, The Netherlands., van Ooijen PMA; Department of Data Science Center in Health, University of Groniningen, University Medical Center Groningen, Groningen, The Netherlands.; Department of Radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands., Gratama JWC; Department of Radiology, Gelre Hospitals, Apeldoorn, The Netherlands., Braam R; Department of Cardiology, Gelre Hospitals, Apeldoorn, The Netherlands., Oudkerk M; Department of Medical Science, University of Groningen, Groningen, The Netherlands., van der Harst P; Department of Cardiology, Division of Heart and Lungs, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Dinant GJ; Department of Family Medicine, Maastricht University, Maastricht, The Netherlands., Vliegenthart R; Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands r.vliegenthart@umcg.nl.
المصدر: BMJ open [BMJ Open] 2022 Apr 19; Vol. 12 (4), pp. e055123. Date of Electronic Publication: 2022 Apr 19.
نوع المنشور: Clinical Trial Protocol; Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Publishing Group Ltd Country of Publication: England NLM ID: 101552874 Publication Model: Electronic Cited Medium: Internet ISSN: 2044-6055 (Electronic) Linking ISSN: 20446055 NLM ISO Abbreviation: BMJ Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
مواضيع طبية MeSH: Coronary Artery Disease*/complications , Coronary Artery Disease*/diagnosis , General Practitioners*, Angina Pectoris/complications ; Angina Pectoris/diagnosis ; Calcium ; Chest Pain/diagnosis ; Chest Pain/etiology ; Coronary Angiography/methods ; Humans ; Multicenter Studies as Topic ; Pragmatic Clinical Trials as Topic ; Predictive Value of Tests ; Quality of Life ; Randomized Controlled Trials as Topic
مستخلص: Introduction: Identifying and excluding coronary artery disease (CAD) in patients with atypical angina pectoris (AP) and non-specific thoracic complaints is a challenge for general practitioners (GPs). A diagnostic and prognostic tool could help GPs in determining the likelihood of CAD and guide patient management. Studies in outpatient settings have shown that the CT-based coronary calcium score (CCS) has high accuracy for diagnosis and exclusion of CAD. However, the CT CCS test has not been tested in a primary care setting. In the COroNary Calcium scoring as fiRst-linE Test to dEtect and exclude coronary artery disease in GPs patients with stable chest pain (CONCRETE) study, the impact of direct access of GPs to CT CCS will be investigated. We hypothesise that this will allow for early diagnosis of CAD and treatment, more efficient referral to the cardiologist and a reduction of healthcare-related costs.
Methods and Analysis: CONCRETE is a pragmatic multicentre trial with a cluster randomised design, in which direct GP access to the CT CCS test is compared with standard of care. In both arms, at least 40 GP offices, and circa 800 patients with atypical AP and non-specific thoracic complaints will be included. To determine the increase in detection and treatment rate of CAD in GP offices, the CVRM registration rate is derived from the GPs electronic registration system. Individual patients' data regarding cardiovascular risk factors, expressed chest pain complaints, quality of life, downstream testing and CAD diagnosis will be collected through questionnaires and the electronic GP dossier.
Ethics and Dissemination: CONCRETE has been approved by the Medical Ethical Committee of the University Medical Center of Groningen.
Trial Registration Number: NTR 7475; Pre-results.
Competing Interests: Competing interests: General practitioners (GPs) in the control condition receive a €50 compensation for the inclusion of five patients, to compensate for the time investment to include patients into the study. We expect that this financial compensation will not lead GPs to include patients due to a financial incentive. RV is supported by an institutional research grant from Siemens Healthineers. The performance of the trial and trial results do not result in a conflict of interest of the authors as there are no other competing interests.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
References: Circ Cardiovasc Imaging. 2017 Feb;10(2):. (PMID: 28174196)
Med Decis Making. 2020 May;40(4):460-473. (PMID: 32431211)
Atherosclerosis. 2014 Mar;233(1):190-5. (PMID: 24529143)
Croat Med J. 2015 Oct;56(5):422-30. (PMID: 26526879)
J Am Coll Cardiol. 1997 Jun;29(7):1542-8. (PMID: 9180117)
Neth Heart J. 2016 May;24(5):332-42. (PMID: 26879946)
Eur Heart J Cardiovasc Imaging. 2020 Oct 20;21(11):1216-1224. (PMID: 32584979)
J Am Coll Cardiol. 1990 Mar 15;15(4):827-32. (PMID: 2407762)
Eur J Prev Cardiol. 2014 Jan;21(1):90-7. (PMID: 22822179)
Value Health. 2020 Feb;23(2):139-150. (PMID: 32113617)
Circulation. 2000 Jul 25;102(4):380-5. (PMID: 10908208)
BMJ. 2001 Feb 10;322(7282):355-7. (PMID: 11159665)
Eur Heart J. 2016 Apr 14;37(15):1232-43. (PMID: 26746631)
Eur Heart J. 2016 Aug 1;37(29):2315-2381. (PMID: 27222591)
Heart. 2007 Apr;93(4):458-63. (PMID: 16790531)
BMC Fam Pract. 2018 Jun 2;19(1):80. (PMID: 29859536)
J Nucl Cardiol. 2014 Jun;21(3):453-66. (PMID: 24683047)
Eur J Prev Cardiol. 2015 Jul;22(7):882-9. (PMID: 24821733)
Int J Cardiol. 2013 Feb 20;163(2):190-5. (PMID: 21689855)
JACC Cardiovasc Imaging. 2016 May;9(5):580-9. (PMID: 27085440)
Eur J Prev Cardiol. 2016 May;23(7):714-21. (PMID: 26358990)
Am J Cardiol. 2001 Jun 15;87(12):1335-9. (PMID: 11397349)
Am J Cardiol. 2015 Mar 15;115(6):738-44. (PMID: 25604930)
Stat Methods Med Res. 2000 Apr;9(2):81-94. (PMID: 10946428)
Coron Artery Dis. 2009 Jun;20(4):281-7. (PMID: 19384193)
Rofo. 2022 Mar;194(3):257-265. (PMID: 35081649)
JACC Cardiovasc Imaging. 2009 Jun;2(6):675-88. (PMID: 19520336)
Eur Heart J Cardiovasc Imaging. 2014 Mar;15(3):267-74. (PMID: 23966421)
Int J Cardiovasc Imaging. 2016 Mar;32(3):525-9. (PMID: 26515964)
J Am Coll Cardiol. 2018 Dec 25;72(25):3233-3242. (PMID: 30409567)
Int J Cardiovasc Imaging. 2015 Dec;31(8):1619-26. (PMID: 26243534)
Atherosclerosis. 2013 Sep;230(1):76-9. (PMID: 23958256)
JAMA Cardiol. 2017 Sep 1;2(9):986-994. (PMID: 28746709)
Radiology. 2013 Oct;269(1):77-83. (PMID: 23788718)
Circulation. 2006 Jan 3;113(1):30-7. (PMID: 16365194)
Eur Heart J. 2013 Oct;34(38):2949-3003. (PMID: 23996286)
Eur Radiol. 2008 Feb;18(2):244-52. (PMID: 17901959)
JACC Cardiovasc Imaging. 2018 Feb;11(2 Pt 1):221-230. (PMID: 28624395)
Eur Heart J. 2020 Jan 14;41(3):407-477. (PMID: 31504439)
BMJ. 1999 Aug 7;319(7206):376-9. (PMID: 10435968)
Indian Heart J. 2015 Nov-Dec;67(6):552-60. (PMID: 26702685)
Int J Cardiol. 2020 Jan 15;299:56-62. (PMID: 31229262)
Eur Heart J Cardiovasc Imaging. 2014 Aug;15(8):886-92. (PMID: 24513880)
Radiology. 2012 Sep;264(3):637-49. (PMID: 22919038)
J Am Coll Cardiol. 1998 Jan;31(1):126-33. (PMID: 9426030)
Am J Cardiol. 2015 Jul 15;116(2):204-7. (PMID: 25958114)
Value Health. 2016 Jun;19(4):343-52. (PMID: 27325326)
Circ Cardiovasc Qual Outcomes. 2019 Jun;12(6):e005375. (PMID: 31163980)
Am J Cardiol. 2009 Dec 1;104(11):1499-504. (PMID: 19932782)
BMJ. 2017 Apr 3;357:j1194. (PMID: 28373173)
Heart. 2017 Nov;103(21):1727-1732. (PMID: 28634285)
BMJ. 2012 Jun 12;344:e3485. (PMID: 22692650)
Fam Pract. 2000 Apr;17(2):192-6. (PMID: 10758085)
فهرسة مساهمة: Keywords: chest pain; computed tomography; coronary artery disease; coronary calcium score; general practitioners; primary care
المشرفين على المادة: SY7Q814VUP (Calcium)
تواريخ الأحداث: Date Created: 20220420 Date Completed: 20220421 Latest Revision: 20220716
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC9020291
DOI: 10.1136/bmjopen-2021-055123
PMID: 35440450
قاعدة البيانات: MEDLINE
الوصف
تدمد:2044-6055
DOI:10.1136/bmjopen-2021-055123