Will Parsonage writes...Next week I'll be presenting on some of our clinical redesign work at this meeting under the title 'NEATs, SLICs and ACREs'. It is a great opportunity to present to a much wider audience on the rationale, method and outcome of the project we have been conducting with the team at Nambour Hospital to translate our research into practice around patients presenting to emergency departments with chest pain.
OK, low risk chest pain in the GP clinic setting. It can be a vexing issue - we always worry about the big, bad diseases we might be missing - but is there a risk (and logistical headache) in doing a thorough workup and serial enzymes / Troponins on all chest pains?
It kinda depends where you practice as to how you will play this one.
There has been lots of media interest in our paper 'Validation of high-sensitivity troponin I in a 2-h diagnostic strategy to assess 30-day outcomes in emergency-department patients with possible acute coronary syndrome' that went online in in the Journal of the American College of Cardiology in the last few days.
Those in Queensland may have heard reference to the study on the ABC Radio news this morning and Louise Cullen has been interviewed today by ABC Radio National and Channel Nine.
A/Prof Louise Cullen writes...
The minefield of differences in troponin assays confuses clinicians, in an area of medicine that is already complex. Determining which patients presenting to Emergency Departments (EDs) with symptoms of possible Acute Coronary Syndromes actually have this underlying diagnosis is challenging. Current guidelines recommend lengthy assessment processes generally not achievable in acceptable time frames for patients to remain in the ED, and thus encourage Emergency Physicians to admit ‘all’ who present with possible symptoms of ACS.
Don't believe the the hype! That's the cardinal rule to obey when reading health news. "Breakthroughs" and "cures" are rare, and should always be viewed with caution and skepticism.
This week was a great example. Last Sunday, the New York Times, the major networks, and a host of other media outlets (including this one) reported on a paper in
Things don’t always get the attention they deserve…
One of the triumphs of the recent ACC 2013 meeting was the the host city of San Francisco and the meeting venue, the Moscone Centre, which is central to downtown San Francisco and it’s associated attractions. One of the notable attractions is the San Francisco Museum of Modern Art (MoMA) right next door to Moscone. In a spare couple of hours during the meeting it was great to be able to call in there for some diversion.
There I was delighted to find one of the replicas of Duchamp’s 1917 work ‘Fountain’ pictured above. If it looks like a urinal that’s because that is what it was. This is no ordinary urinal but one that in 2004 was voted one of the most influential modern art works of all time (and therefore possibly one of the most important works in the MoMA). Duchamp’s 1917 original was lost but celebrated by a series of replicas – this one, in the MoMA quietly celebrating the 50th anniversary of its creation in 1963. Unceremoniously placed on a non-descript, plain white plinth garners a level of inattention that I am sure the artist would perhaps have appreciated. I took the short movie below to illustrate this (you can see ‘Fountain’ centre frame on the white box).
It was in no way my intention, but a matter of fact, that I didn’t attend any of the late breaking clinical trial sessions at the recent ACC meeting. In fact, I admit to taking at least 24 hours to figure out what an LBCT actually was (a new mode of cardiac imaging that had passed me by?).
I enjoyed blogging some of the less travelled sessions of the meeting (Day 1, Day 2, Day 3). So I feel I did my bit for some of the things that don’t get the attention they deserve but for those in need of a good summary of the headline trials, that did garner most of the attention, here are a few suggestions.
Here is perhaps the definitive video summary of the key trials from the heart.org’s Cardiology Show
...and here a more personal view from Melissa Walton-Shirleys “Heartfelt’ blog, also on the heart.org
…and in a slightly different format a slideshow of the key findings of the major trials that were presented at the meeting.
Plenty to be getting on with there…