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 : study protocol for randomized controlled trial. / Newby, David E; Williams, Michelle C. (Lead / Corresponding author); Flappan, Andrew D; Forbes, John F; Hargreaves, Allister D; Leslie, Stephen J; Lewis, Steff C; McKillop, Graham; McLean, Scott; Reid, John; Spratt, James C; Uren, Neal G; van Beek, Edwin J; Boon, Nicholas A; Clark, Liz; Craig, Peter; Flather, Marcus D; McCormack, Chiara; Roditi, Giles; Timmis, Adam D; Krishan, Ashma; Donaldson, Gillian; Fotheringham, Marlene; Hall, Fiona J; Neary, Paul; Cram, Louisa; Perkins, Sarah; Taylor, Fiona; Eteiba, Hany; Rae, Alan P; Robb, Kate; Barrie, Dawn; Bissett, Kim; Dawson, Adelle; Dundas, Scot; Fogarty, Yvonne; Ramkumar, Prasad G; Houston, Graeme J.; Letham, Deborah; O'Neill, Linda; Pringle, Stuart D.; Ritchie, Valerie; Sudarshan, Thiru; Weir-McCall, Jonathan; Cormack, Alistair; Findlay, Iain N; Hood, Stuart; Murphy, Clare; Peat, Eileen; Allen, Barbara; Bertram, Danielle; Brian, David; Cowan, Amy; Cruden, Nicholas L; Dweck, Marc R; Flint, Laura; Fyfe, Samantha; Harding, Collette; MacGillivray, Tom J; Maclachlan, David S; Macleod, Margaret; Misadraee, Saeed; Morrison, Avril; Mills, Nicholas L; Phillips, Alyson; Queripel, Laura J; Weir, Nicholas W; Bett, Fiona; Divers, Frances; Fairley, Katie; Jacob, Ashok J; Keegan, Edith; White, Tricia; Gemmil, John; Henry, Margo; McGowan, James; Dinnel, Lorraine; Francis, Marc C; Sandeman, Dennis; Yerramasu, Ajay; Morrison, Avril; Berry, Colin; Boylan, Heather; Brown, Ammani; Duffy, Karen; Frood, Alison; Johnstone, Janet; Langhan, Kirsten; Macduff, Ross; MacLeod, Martin; McGlynn, Deborah; McMillan, Nigel; Murdoch, Laura; Noble, Colin; Paterson, Victoria; Roditi, Giles; Steedman, Tracey; Tzemos, Nikolaos; Baird, Andrew; Minns, Fiona C.
In: Trials, Vol. 13, 184, 2012.Research output: Contribution to journal › Article
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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 - Trials
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 D.
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 - Morrison,Avril
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 - Roditi,Giles
AU - Steedman,Tracey
AU - Tzemos,Nikolaos
AU - Baird,Andrew
AU - Minns,Fiona C.
PY - 2012
Y1 - 2012
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
M3 - Article
VL - 13
JO - Trials
JF - Trials
SN - 1745-6215
M1 - 184
ER -