دورية أكاديمية
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.
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. |
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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.) |
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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: 20240826 |
رمز التحديث: | 20240826 |
مُعرف محوري في PubMed: | PMC9020291 |
DOI: | 10.1136/bmjopen-2021-055123 |
PMID: | 35440450 |
قاعدة البيانات: | MEDLINE |
تدمد: | 2044-6055 |
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DOI: | 10.1136/bmjopen-2021-055123 |