Multi-centre evaluation of the role of chest pain units in the NHS
| ISRCTN | ISRCTN55318418 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN55318418 |
| Protocol serial number | SDO/2002/41 |
| Sponsor | NHS Service Delivery and Organisation Programme (SDO) (UK) |
| Funder | NHS Service Delivery & Organisation National R&D Programme (UK) (ref: SDO/2002/41) |
- Submission date
- 09/09/2005
- Registration date
- 02/11/2005
- Last edited
- 05/02/2016
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Circulatory System
Plain English summary of protocol
Background and study aims
Chest pain is extremely common and can be caused by a wide range of conditions. If the problem is related to the heart, it is very important to reach a quick and accurate diagnosis to avoid future complications. For this reason, many patients who come into emergency departments with chest pain are admitted to hospital for observation, even if they do not need to be. On the other hand, some patients who do have problems which require urgent treatment may be discharged if a diagnosis cannot be reached using standard tests. The concept of the chest pain observation unit has been developed to address these problems. These units offer a more in-depth examination of patients with chest pain in order to determine whether patients need to be admitted or discharged from hospital more accurately. The aim of this study is to evaluate the effectiveness of CPUs in the emergency care and accurate diagnosis of chest pain patients
Who can participate?
Adults who have come into Accident and Emergency (A&E) with chest pain.
What does the study involve?
Hospitals are randomly allocated to one of two groups. For hospitals in the first group, a dedicated chest pain observation unit (CPU) is set up. This unit is staffed by three experienced chest pain nurses who have a background in caring for heart patients or emergency medicine. Patients who attend these hospitals with chest pain go into the CPU (on the same day or the following day if out of hours) and receive in-depth tests on their heart function. Patients who are found to have a heart problem are admitted to hospital for further observation. For hospitals in the second group, patients coming into A&E with chest pain are treated in the department in the usual way (at the discretion of the medical staff in that emergency department).
What are the possible benefits and risks of participating?
Not provided at time of registration.
Where is the study run from?
14 NHS hospitals with an Accident and Emergency (A&E) department (UK)
When is the study starting and how long is it expected to run for?
July 2015 to July 2017
Who is funding the study?
NHS Service Delivery & Organisation National R&D Programme (UK)
Who is the main contact?
Dr Steve Goodacre
s.goodacre@sheffield.ac.uk
Contact information
Scientific
Health Services Research
ScHARR
University of Sheffield
Regent Court
30 Regent Street
Sheffield
S1 4DA
United Kingdom
| Phone | +44 (0)114 222 0842 |
|---|---|
| s.goodacre@sheffield.ac.uk |
Study information
| Primary study design | Interventional |
|---|---|
| Study design | Multi-centre randomised controlled trial |
| Secondary study design | Randomised controlled trial |
| Scientific title | Randomised controlled trial and economic evaluation of a chest pain observation unit compared with routine care |
| Study acronym | ESCAPE (Effectiveness and Safety of Chest pain Assessment to Prevent Emergency admissions) |
| Study objectives | To evaluate whether Chest Pain Units (CPUs) provide a system of care for emergency patients with acute chest pain that is effective, acceptable, and cost-effective, compared to routine emergency care. |
| Ethics approval(s) | Not provided at time of registration. |
| Health condition(s) or problem(s) studied | Acute chest pain |
| Intervention | 1. Fourteen acute NHS hospitals will be selected and randomised so that seven implement CPU care and seven continue to provide routine care 2. Postal questionnaire survey to random sample of 400 patients attending A&E with chest pain over 2 years 3. Face-to-face interviews carried out with random sample of patients who have attended A&E with acute chest pain |
| Intervention type | Other |
| Primary outcome measure(s) |
Proportion of patients admitted to hospital in 2 years. |
| Key secondary outcome measure(s) |
No secondary outcome measures |
| Completion date | 30/11/2006 |
Eligibility
| Participant type(s) | Patient |
|---|---|
| Age group | Adult |
| Sex | All |
| Target sample size at registration | 8700 |
| Key inclusion criteria | Participants will be eligible if they attend Accident and Emergency (A&E) department with a presenting complaint of chest pain or a similar pre-specified term (such as angina or heart attack). |
| Key exclusion criteria | Routine data will be collected for all patients. Potential participants will not be randomly selected for postal questionnaire survey if they are identified as having died by 30 days after attendance. |
| Date of first enrolment | 01/12/2003 |
| Date of final enrolment | 30/11/2006 |
Locations
Countries of recruitment
- United Kingdom
- England
Study participating centre
S1 4DA
United Kingdom
Results and Publications
| Individual participant data (IPD) Intention to share | No |
|---|---|
| IPD sharing plan summary | Not provided at time of registration |
| IPD sharing plan |
Study outputs
| Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
|---|---|---|---|---|---|
| Results article | results | 31/01/2004 | Yes | No | |
| Results article | results | 01/08/2004 | Yes | No | |
| Results article | results | 29/09/2007 | Yes | No | |
| Results article | results | 01/10/2010 | Yes | No | |
| Study website | Study website | 11/11/2025 | 11/11/2025 | No | Yes |
Editorial Notes
05/020/2016: Added plain English summary.
