The RATPAC (Randomised Assessment of Treatment using Panel Assay of Cardiac markers) trial: a randomised controlled trial of point-of-care cardiac markers in the emergency department
Goodacre S, Bradburn M, Fitzgerald P, Cross E, Collinson P, Gray A, Hall AS
Record ID 32007000880
English
Authors' objectives:
We aimed to measure the effect of using a point-of-care cardiac marker panel upon successful discharge home after emergency department (ED) assessment, length of hospital stay, use of coronary care, cardiac tests and treatments, subsequent hospital attendance and/or admission, and major adverse events, and then estimate the cost-effectiveness of the point-of-care panel in terms of mean costs and quality-adjusted life-years (QALYs) accrued compared with standard care.
Authors' recommendations:
Point-of-care panel assessment increases the proportion of patients successfully discharged home, leading to reduced median length of initial hospital stay, but no change in mean hospital stay or total inpatient days. Point-of-care panel assessment is associated with increased use of coronary care and may be associated with increased use of other interventions. Cost-effectiveness is mainly driven by differences in mean cost, with point estimates suggesting that point-of-care panel assessment is £211 per patient more expensive than standard care. It is unlikely to be considered cost-effective in the NHS, with a 0.888 probability that standard care is dominant.
Further research is required to identify factors that influence the effectiveness and cost-effectiveness of point-of-care panel assessment, explore alternative ways of managing patients with low-risk chest pain and evaluate new cardiac biomarkers.
Details
Project Status:
Completed
URL for project:
http://www.hta.ac.uk/1602
Year Published:
2011
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
England, United Kingdom
MeSH Terms
- Immunoassay
- Outcome Assessment, Health Care
- Sensitivity and Specificity
- Angina Pectoris
- Biomarkers
- Chest Pain
- Myocardial Infarction
Contact
Organisation Name:
NIHR Health Technology Assessment programme
Contact Address:
NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name:
journals.library@nihr.ac.uk
Contact Email:
journals.library@nihr.ac.uk
Copyright:
2011 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.