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Clinical Informatics

Pre-hospital Thrombolysis and Telemedicine in the NHS: A Business Case and Appraisal of the Literature

Index:

  1. Introduction and Definitions of Business Case, Telemedicine and Thrombolysis

  2. Strategic context in the NHS

  3. Objectives and Stakeholders of Pre-hospital Thrombolysis

  4. Available Options for Pre-hospital Thrombolysis
  5. Tabulated Appraisal of Short List

    1. Option 1
    2. Option 2 and 3

  6. Summary of Appraisals and Executive Summary

  7. References

References

  1. Wootton and Craig. Introduction to Telemedicine. The Royal Society of Medicine Press Ltd. 1999. Chapter 1; page 6.

  2. CEC DG XIII. Research and Technology Development on Telematics Systems in Health Care. Annual technical Report on RTD in heath care. Brussels: AIM, 1993.

  3. Boersma E, Maas AC, Deckers JW, Simoons ML. Early thrombolytic treatment in acute myocardial infarction: reappraisal of the golden hour. Lancet 1996; 348:771–5.

  4. Weaver WD. Time to thrombolytic treatment: factors affecting delay and their influence on outcome. J Am Coll Cardiol 1995; 25: 3S–9S.

  5. Reimer KA, Lowe JE, Rasmussen MM, Jennings RB. The wave-front phenomenon of ischemic cell death: 1 myocardial infarct size versus duration of coronary occlusion in dogs. Circulation 1977; 56: 786–94.

  6. Flameng W, Lesaffre E, Vanhaecke J. Determinants of infarct size in non-human primates. Bas Res Cardiol 1990; 85: 392–403.

  7. Reimer KA, Vander Heide RS, Richard VJ. Reperfusion in acute myocardial infarction: effect of timing and modulating factors in experimental models. Am J Cardiol 1993; 72: 13G–21G.

  8. Dorado DG, Théroux P, Elizaga J, et al. Myocardial infarction in the pig heart model: infarct size and duration of coronary occlusion. Cardiovasc Res 1987; 21: 537–44.

  9. Koren G, Weiss A, Hasin Y, et al. Prevention of myocardial damage in acute myocardial ischemia by early treatment with intravenous streptokinase. N Engl J Med 1985; 313:1384–9.

  10. Gruppo Italiano per lo Studio della Streptochinasi nell’Infarto Miocardico (GISSI): Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1986; 1:397–401.

  11. Timm TC, Ross R, McKendall GR, Braunwald E, Williams DO, and the TIMI Investigators: Left ventricular function and early cardiac events as a function of time to treatment with t-PA: A report from TIMI II (abstr). Circulation 1991; 84(suppl):II-230.

  12. Cannon CP, Braunwald E: GUSTO, TIMI and the case for rapid reperfusion. Acta Cardiol 1994; 49:1–8.

  13. Topol EJ, Califf RM, Lee KL: More on the GUSTO trial. N Engl J Med 1994; 331:277–278 (Published errata appear in N Engl J Med 1994; 331:687, and 1994; 331:1323).

  14. Newby LK, Rutsch WR, Califf RM, Simoons ML, Aylward PE, Armstrong PW, Woodlief LH, Lee KL, Topol EJ, Van de Werf F (GUSTO-1 Investigators): Time from symptom onset to treatment and outcomes after thrombolytic therapy. J Am Coll Cardiol 1996; 27:1646–1655.

  15. O’Keefe JH, Rutherford BD, McConahay DR, Ligon RW, Johnson WL, Giorgi LV, Crockett JE, McCallister BD, Conn RD, Gura GM, Good TH, Steinhaus DM, Bateman TM, Shimsham TM, Hartzler GO: Early and late results of coronary angioplasty without antecedent thrombolytic therapy for acute myocardial infarction. Am J Cardiol 1989; 64:1221–1230.

  16. Cannon CP: Time to treatment: A crucial factor in Thrombolysis and primary angioplasty. J Thromb Thrombolysis 1996; 3:249–256.

  17. Taher T, Fu Y, Wagner GS, et al. Aborted myocardial infarction in patients with ST-segment elevation: insights from the assessment of the safety and efficacy of a new thrombolytic regimen-3 trial electrocardiographic substudy. J Am Coll Cardiol 2004; 44:38–43.

  18. Welsh RC, Armstrong PW. It's a matter of time: contemporary pre-hospital management of acute ST elevation myocardial infarction. Heart. 2005 Dec; 91(12): 1524-6.

  19. Department of Health UK. National Service Frameworks for Coronary Heart Disease. 2000.

  20. Department of Health UK. NHS Plan. 2000.

  21. Royal College of Physician UK. Myocardial Infarction Audit Project (MINAP).

  22. Health Care Commission, UK. Thrombolysis - 60 minutes call to needle time.

  23. Royal College of Physician UK. How the NHS Manages Heart Attacks. 2004-2005.

  24. Rawles JM. Call to needle times after acute myocardial infarction. New standard of 60 minutes has been proposed but may be too rigorous. BMJ 1999; 318:1554.

  25. Pedley DK, Bissett K, Connolly EM, Goodman CG, Golding I, Pringle TH, et al. Prospective observational cohort study of time saved by pre-hospital thrombolysis for ST elevation myocardial infarction delivered by paramedics. BMJ 2003; 327: 22-26
  26. Morrison LJ, Verbeek PR, McDonald AC, Sawadsky BV, Cook DJ. Mortality and pre-hospital thrombolysis for acute myocardial infarction. A meta-analysis. JAMA 2000; 283:2686-92.

  27. GREAT Group. Feasibility, safety and efficacy of domiciliary thrombolysis by general practitioners: Grampian region anistreplase trial: BMJ 1992; 305:548-53.

  28. The European Myocardial Infarction Project Group. Pre-hospital thrombolytic therapy in patients with suspected acute myocardial infarction. N Engl J Med 1993; 329:383-9.

  29. Weaver WD, Cerqueira M, Hallstrom AP, Litwin PE, Martin JS, Kudenchuk PJ, et al. Prehospital-initiated vs. hospital-initiated thrombolytic therapy. The Myocardial Infarction Triage and Intervention Trial (MITI). JAMA 1993; 270:1211-6.

  30. Morrow DA, Antman EM, Sayah A, et al. Evaluation of the time saved by pre-hospital initiation of reteplase for ST-elevation myocardial infarction: results of the early retavase thrombolysis in myocardial infarction (ER-TIMI) 19 trial. J Am Coll Cardiol 2002; 3:40:71-7.

  31. LeMay MR, Labinaz M, Turek M, et al. Combined Angioplasty and Pharmacological Intervention versus Thrombolytics Alone in Acute Myocardial Infarction (CAPITAL-AMI). Program and abstracts from the American College of Cardiology 53rd Annual Scientific Session; March 7-10, 2004; New Orleans, Louisiana. Late-Breaking Clinical Trials and Trial Updates: Novel Therapies for Acute Myocardial Infarction.

  32. Ellis SG, Armstrong P, Betriu A, et al. Facilitated percutaneous coronary intervention versus primary percutaneous coronary intervention: design and rationale of the Facilitated Intervention with Enhanced Reperfusion Speed to Stop Events (FINESSE) trial Am Heart J 2004; 147:E16.

  33. Li RH, Herrmann HC. Facilitated percutaneous coronary intervention: a novel concept in expediting and improving acute myocardial infarction care. Am Heart J 2000; 140:S125-35.

  34. Royal Colleges Ambulance Liaison Committee/Ambulance Services Association. Pre-hospital thrombolysis. London: National Institute for Clinical Excellence, 2001. (Technology appraisals process series 4).

  35. Phil Keeling, Debbie Hughes, Linnie Price, Steve Shaw, Andy Barton. Safety and feasibility of pre-hospital thrombolysis carried out by paramedics. BMJ 2003; Vol 327: 27-8.

  36. Millar-Craig MW, Joy AV, Adamovicz M et al. Reduction in treatment delay by paramedic diagnosis of myocardial infarction with direct CCU admission. Heart 1997; 78:456-61.

  37. Sandler DA. Paramedic direct admission of heart attack patients to a coronary care unit. Lancet 1998; 352:1198.

  38. Karagounis L, Ipsen SK, Jessop MR, Gilmore KM, Valenti DA, Clawson JJ, Teichman S, Anderson JL: Impact of field-transmitted electrocardiography on time to in-hospital thrombolytic therapy in acute myocardial infarction. Am J Cardiol 1990;66:786–791.

  39. Health Technology Assessment, National Institute for Health Research, UK . Early thrombolysis for the treatment of acute myocardial infarction: a systematic review and economic evaluation. 2003; Vol. 7: No 15, Page 75

 

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