Standardizing Emergency Work-ups Around Risk Data



Status:Recruiting
Conditions:Angina, Cardiology, Hospital
Therapuetic Areas:Cardiology / Vascular Diseases, Other
Healthy:No
Age Range:18 - Any
Updated:2/1/2019
Start Date:July 1, 2018
End Date:February 2020
Contact:Dustin G Mark, MD
Email:dustin.g.mark@kp.org
Phone:510-891-3785

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Standardizing Emergency Work-ups Around Risk Data (STEWARD): The CREST Network Chest Pain Project

Chest pain is the second leading reason for emergency department (ED) visits in the United
States. Resource utilization for this ED subpopulation is particularly high, in part due to a
dearth of accepted standardized clinical approaches and general overestimation of risk on the
part of both providers and patients. This prospective observational cohort study seeks to
address this issue by providing externally validated risk scores for major adverse cardiac
events using a web-based clinical decision support platform (RISTRA) embedded within the
electronic health record at 13 Kaiser Permanente Northern California (KPNC) EDs over a
12-month period. The decision support will provide risk estimates specific to the KPNC
patient population. This studies hypothesis is that the provision of more accurate risk
estimation for major adverse cardiac events will improve informed decision making by both
providers and patients, resulting in less provocative testing and lower ED lengths of stay
amongst low risk patients, as well as improving medical management among non-low risk
patients and decreasing future rates of major adverse cardiac events.


Inclusion Criteria:

- Emergency department chief complaint of chest pain or chest discomfort

- Clinical concern for possible cardiac ischemia
We found this trial at
12
sites
39400 Paseo Padre Parkway
Fremont, California 94538
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Fremont, CA
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Antioch, CA
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280 West MacArthur Boulevard
Oakland, California 94611
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Oakland, CA
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901 Nevin Avenue
Richmond, California 94801
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Richmond, CA
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Roseville, CA
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6600 Bruceville Rd
Sacramento, California 95823
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Sacramento, CA
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2025 Morse Avenue
Sacramento, California 95825
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Sacramento, CA
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2425 Geary Boulevard
San Francisco, California 94115
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San Francisco, CA
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2500 Merced Street
San Leandro, California 94577
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San Leandro, CA
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99 Montecillo Road
San Rafael, California 94903
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San Rafael, CA
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1200 El Camino Real
South San Francisco, California 94080
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South San Francisco, CA
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Walnut Creek, CA
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