The T-MACS Choice Feasibility Study
Research type
Research Study
Full title
The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) Choice Feasibility Study
IRAS ID
271018
Contact name
Richard Body
Contact email
Sponsor organisation
The University of Manchester
Duration of Study in the UK
0 years, 6 months, 2 days
Research summary
Every day approximately 1.4 million patients with chest pain attend emergency departments (ED’s) in the UK. Emergency doctors then need to decide who requires hospital admission and who is safe to be discharged home. While the clinical assessment is important it is often not enough to reliably predict if a patient is likely to have a heart related event. Therefore, clinicians have come to increasingly rely on risk prediction models. However, the personal risk and options available are not universally shared with patients leading to a situation where doctors alone decide what is best.
In this study funded by the Royal College of Emergency Medicine we want to understand if testing the implementation of shared decision-making as a new communication strategy for adult patients with chest pain in the ED can practically be done. This is important so we know what needs improving before proceeding to a larger scale study to definitively proof benefits of shared decision-making.
To answer our question, we will survey adult patients with chest pain attending the ED (1 survey following the clinical encounter and 1 survey at 30 days on patient permission) and clinicians (1 survey about training and 1 survey following seeing a patient with chest pain) about their experience without affecting clinical care.
The study will take place in the ED’s of the Manchester Royal Infirmary and Albert Edward Infirmary while the ED’s transition through three stages:
- from their current unstructured communication practice (2 months)
- through a physician training stage (1 months)
- to the shared decision-making stage (2 months) where doctors will use a co-designed decision aid to facilitate communication of the patients personal risk.With the patient’s permission we will follow them up at 30 days by contacting their general practitioner and checking their medical records to see if they had any heart related events.
REC name
Wales REC 7
REC reference
21/WA/0255
Date of REC Opinion
26 Aug 2021
REC opinion
Favourable Opinion