TY  - JOUR
T1  - Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial
T2  - study protocol for randomized controlled trial
A1  - Newby,David E
A1  - Williams,Michelle C
A1  - Flappan,Andrew D
A1  - Forbes,John F
A1  - Hargreaves,Allister D
A1  - Leslie,Stephen J
A1  - Lewis,Steff C
A1  - McKillop,Graham
A1  - McLean,Scott
A1  - Reid,John
A1  - Spratt,James C
A1  - Uren,Neal G
A1  - van Beek,Edwin J
A1  - Boon,Nicholas A
A1  - Clark,Liz
A1  - Craig,Peter
A1  - Flather,Marcus D
A1  - McCormack,Chiara
A1  - Roditi,Giles
A1  - Timmis,Adam D
A1  - Krishan,Ashma
A1  - Donaldson,Gillian
A1  - Fotheringham,Marlene
A1  - Hall,Fiona J
A1  - Neary,Paul
A1  - Cram,Louisa
A1  - Perkins,Sarah
A1  - Taylor,Fiona
A1  - Eteiba,Hany
A1  - Rae,Alan P
A1  - Robb,Kate
A1  - Barrie,Dawn
A1  - Bissett,Kim
A1  - Dawson,Adelle
A1  - Dundas,Scot
A1  - Fogarty,Yvonne
A1  - Ramkumar,Prasad G
A1  - Houston,Graeme J
A1  - Letham,Deborah
A1  - O'Neill,Linda
A1  - Pringle,Stuart
A1  - Ritchie,Valerie
A1  - Sudarshan,Thiru
A1  - Weir-McCall,Jonathan
A1  - Cormack,Alistair
A1  - Findlay,Iain N
A1  - Hood,Stuart
A1  - Murphy,Clare
A1  - Peat,Eileen
A1  - Allen,Barbara
A1  - Bertram,Danielle
A1  - Brian,David
A1  - Cowan,Amy
A1  - Cruden,Nicholas L
A1  - Dweck,Marc R
A1  - Flint,Laura
A1  - Fyfe,Samantha
A1  - Harding,Collette
A1  - Macgillivray,Tom J
A1  - Maclachlan,David S
A1  - Macleod,Margaret
A1  - Misadraee,Saeed
A1  - Morrison,Avril
A1  - Mills,Nicholas L
A1  - Phillips,Alyson
A1  - Queripel,Laura J
A1  - Weir,Nicholas W
A1  - Bett,Fiona
A1  - Divers,Frances
A1  - Fairley,Katie
A1  - Jacob,Ashok J
A1  - Keegan,Edith
A1  - White,Tricia
A1  - Gemmil,John
A1  - Henry,Margo
A1  - McGowan,James
A1  - Dinnel,Lorraine
A1  - Francis,Marc C
A1  - Sandeman,Dennis
A1  - Yerramasu,Ajay
A1  - Berry,Colin
A1  - Boylan,Heather
A1  - Brown,Ammani
A1  - Duffy,Karen
A1  - Frood,Alison
A1  - Johnstone,Janet
A1  - Langhan,Kirsten
A1  - Macduff,Ross
A1  - Macleod,Martin
A1  - McGlynn,Deborah
A1  - McMillan,Nigel
A1  - Murdoch,Laura
A1  - Noble,Colin
A1  - Paterson,Victoria
A1  - Steedman,Tracey
A1  - Tzemos,Nikolaos
A1  - Baird,Andrew
A1  - Minns,Fiona C
AU  - Newby,David E
AU  - Williams,Michelle C
AU  - Flappan,Andrew D
AU  - Forbes,John F
AU  - Hargreaves,Allister D
AU  - Leslie,Stephen J
AU  - Lewis,Steff C
AU  - McKillop,Graham
AU  - McLean,Scott
AU  - Reid,John
AU  - Spratt,James C
AU  - Uren,Neal G
AU  - van Beek,Edwin J
AU  - Boon,Nicholas A
AU  - Clark,Liz
AU  - Craig,Peter
AU  - Flather,Marcus D
AU  - McCormack,Chiara
AU  - Roditi,Giles
AU  - Timmis,Adam D
AU  - Krishan,Ashma
AU  - Donaldson,Gillian
AU  - Fotheringham,Marlene
AU  - Hall,Fiona J
AU  - Neary,Paul
AU  - Cram,Louisa
AU  - Perkins,Sarah
AU  - Taylor,Fiona
AU  - Eteiba,Hany
AU  - Rae,Alan P
AU  - Robb,Kate
AU  - Barrie,Dawn
AU  - Bissett,Kim
AU  - Dawson,Adelle
AU  - Dundas,Scot
AU  - Fogarty,Yvonne
AU  - Ramkumar,Prasad G
AU  - Houston,Graeme J
AU  - Letham,Deborah
AU  - O'Neill,Linda
AU  - Pringle,Stuart
AU  - Ritchie,Valerie
AU  - Sudarshan,Thiru
AU  - Weir-McCall,Jonathan
AU  - Cormack,Alistair
AU  - Findlay,Iain N
AU  - Hood,Stuart
AU  - Murphy,Clare
AU  - Peat,Eileen
AU  - Allen,Barbara
AU  - Bertram,Danielle
AU  - Brian,David
AU  - Cowan,Amy
AU  - Cruden,Nicholas L
AU  - Dweck,Marc R
AU  - Flint,Laura
AU  - Fyfe,Samantha
AU  - Harding,Collette
AU  - Macgillivray,Tom J
AU  - Maclachlan,David S
AU  - Macleod,Margaret
AU  - Misadraee,Saeed
AU  - Morrison,Avril
AU  - Mills,Nicholas L
AU  - Phillips,Alyson
AU  - Queripel,Laura J
AU  - Weir,Nicholas W
AU  - Bett,Fiona
AU  - Divers,Frances
AU  - Fairley,Katie
AU  - Jacob,Ashok J
AU  - Keegan,Edith
AU  - White,Tricia
AU  - Gemmil,John
AU  - Henry,Margo
AU  - McGowan,James
AU  - Dinnel,Lorraine
AU  - Francis,Marc C
AU  - Sandeman,Dennis
AU  - Yerramasu,Ajay
AU  - Berry,Colin
AU  - Boylan,Heather
AU  - Brown,Ammani
AU  - Duffy,Karen
AU  - Frood,Alison
AU  - Johnstone,Janet
AU  - Langhan,Kirsten
AU  - Macduff,Ross
AU  - Macleod,Martin
AU  - McGlynn,Deborah
AU  - McMillan,Nigel
AU  - Murdoch,Laura
AU  - Noble,Colin
AU  - Paterson,Victoria
AU  - Steedman,Tracey
AU  - Tzemos,Nikolaos
AU  - Baird,Andrew
AU  - Minns,Fiona C
PY  - 2012/10/4
Y1  - 2012/10/4
N2  - ABSTRACT: BACKGROUND: Rapid access chest pain clinics have facilitated the early diagnosis and treatment of patients with coronary heart disease and angina. Despite this important service provision, coronary heart disease continues to be under-diagnosed and many patients are left untreated and at risk. Recent advances in imaging technology have now led to the widespread use of noninvasive computed tomography, which can be used to measure coronary artery calcium scores and perform coronary angiography in one examination. However, this technology has not been robustly evaluated in its application to the clinic.Methods/designThe SCOT-HEART study is an open parallel group prospective multicentre randomized controlled trial of 4,138 patients attending the rapid access chest pain clinic for evaluation of suspected cardiac chest pain. Following clinical consultation, participants will be approached and randomized 1:1 to receive standard care or standard care plus >=64-multidetector computed tomography coronary angiography and coronary calcium score. Randomization will be conducted using a web-based system to ensure allocation concealment and will incorporate minimization. The primary endpoint of the study will be the proportion of patients diagnosed with angina pectoris secondary to coronary heart disease at 6 weeks. Secondary endpoints will include the assessment of subsequent symptoms, diagnosis, investigation and treatment. In addition, long-term health outcomes, safety endpoints, such as radiation dose, and health economic endpoints will be assessed. Assuming a clinic rate of 27.0% for the diagnosis of angina pectoris due to coronary heart disease, we will need to recruit 2,069 patients per group to detect an absolute increase of 4.0% in the rate of diagnosis at 80% power and a two-sided P value of 0.05. The SCOT-HEART study is currently recruiting participants and expects to report in 2014. DISCUSSION: This is the first study to look at the implementation of computed tomography in the patient care pathway that is outcome focused. This study will have major implications for the management of patients with cardiovascular disease.Trial registrationClinicalTrials.gov Identifier: NCT01149590.
AB  - ABSTRACT: BACKGROUND: Rapid access chest pain clinics have facilitated the early diagnosis and treatment of patients with coronary heart disease and angina. Despite this important service provision, coronary heart disease continues to be under-diagnosed and many patients are left untreated and at risk. Recent advances in imaging technology have now led to the widespread use of noninvasive computed tomography, which can be used to measure coronary artery calcium scores and perform coronary angiography in one examination. However, this technology has not been robustly evaluated in its application to the clinic.Methods/designThe SCOT-HEART study is an open parallel group prospective multicentre randomized controlled trial of 4,138 patients attending the rapid access chest pain clinic for evaluation of suspected cardiac chest pain. Following clinical consultation, participants will be approached and randomized 1:1 to receive standard care or standard care plus >=64-multidetector computed tomography coronary angiography and coronary calcium score. Randomization will be conducted using a web-based system to ensure allocation concealment and will incorporate minimization. The primary endpoint of the study will be the proportion of patients diagnosed with angina pectoris secondary to coronary heart disease at 6 weeks. Secondary endpoints will include the assessment of subsequent symptoms, diagnosis, investigation and treatment. In addition, long-term health outcomes, safety endpoints, such as radiation dose, and health economic endpoints will be assessed. Assuming a clinic rate of 27.0% for the diagnosis of angina pectoris due to coronary heart disease, we will need to recruit 2,069 patients per group to detect an absolute increase of 4.0% in the rate of diagnosis at 80% power and a two-sided P value of 0.05. The SCOT-HEART study is currently recruiting participants and expects to report in 2014. DISCUSSION: This is the first study to look at the implementation of computed tomography in the patient care pathway that is outcome focused. This study will have major implications for the management of patients with cardiovascular disease.Trial registrationClinicalTrials.gov Identifier: NCT01149590.
U2  - 10.1186/1745-6215-13-184
DO  - 10.1186/1745-6215-13-184
M1  - Article
JO  - Trials
JF  - Trials
VL  - 13
ER  -