PROJECT
The TropED study
Evaluating a new chest pain test in emergency departments
Each year, more than half a million Australians attend emergency departments with chest pain. Some of these patients are quickly diagnosed as having an acute heart attack, but most are admitted to hospital for investigation, observation and medical attention.
A new blood test, which is more sensitive to detecting troponin than previous tests, offers the promise of more efficient detection of heart muscle damage in people suffering from chest pain. This new test, however, has not been routinely evaluated.
The National Health and Medical Research Council (NHMRC) funded study is collecting data from national hospitals to evaluate the treatment, management, cost and health outcomes before and after the use of this new blood testing method.
We aim to determine the impact of switching from the older, non-highly sensitive troponin testing to the new, highly sensitive troponin test for patients with chest pain who present to emergency departments.
Specifically, it will look at:
- resource utilisation and clinical management,
- 30-day and one-year clinical outcomes, and
- cost-effectiveness
The research team leader for this study is UWA School of Population and Global Health Dr Siobhan Hickling and over $1 million in funding has been received from the NHMRC for this work.
PhD opportunities
The PhD research involved for the TropED study includes examining data from a major Perth hospital before and after the introduction of the new test, as well as looking at data from a major Queensland hospital where the test has not yet been introduced.
The PhD student will compare:
- the length of time spent in the emergency department and in hospital with the introduction of the new test.
- the health outcomes of patients one month and one year after attending the emergency department for chest pain before the introduction of the new test.
Requirements specific to this project include having quantitative skills or experience in analysing large datasets, or willingness to undergo additional training in this area.
To apply to work on this project, contact Dr Siobhan Hickling on the details listed below.
Readings
For background information on this study, read the below:
- Scott I, Cullen L, Tate JR, ParsonageW. Highly sensitive troponin assays — a two-edged sword? Med J Aust2012; 197:320-323
- Chew DP, Briffa TG, Alhammad NJ, High Sensitivity-Troponin Elevation Secondary to Non-Coronary Diagnoses and Late Death and Recurrent Myocardial Infarction: a causal analysis. Eur Heart J: Acute Cardiovasc Care. 12/12/14 DOI: 10.1177/2048872614564083
- Cullen L, French JK, Briffa TG, Availability of highly sensitive troponin assays and acute coronary syndrome care: insights from the SNAPSHOT registry MJA2015; 202: 36-39.
- Parsonage WA, Greenslade JH, Hammett CJ, al.Validation of an accelerated high-sensitivity troponin T assay protocol in an Australian cohort with chest pain. Med J Aust2014;200:161-165.
- Cullen L, Carlton E, Than M, etal. Sex-specific versus overall cut-points for a high sensitivity troponin I assay in predicting 1-year outcomes. Heart2016;102:120–6.
- CullenLGreenslade JH, Merollini K, Cost and outcomes of assessing patients with chest pain in an Australian Emergency Department. Med J Aust2015; 202:427-32.
Contact Dr Siobhan Hickling
School of Population and Global Health