Ambulance smartphone tool for field triage of ruptured aortic aneurysms (FILTR): study protocol for a prospective observational validation of diagnostic accuracy. Issue 10 (24th October 2016)

• Record Type: Journal Article
• Authors: Lewis, Thomas L; Fothergill, Rachael T; Karthikesalingam, Alan
• Other Names: author non-byline.; Zipfel Rebecca author non-byline.; Azhar Bilal author non-byline.; Bahia Sandeep author non-byline.; Bayly Edward author non-byline.; Bennett Joanna author non-byline.; Cheetham Anne author non-byline.; Damiani Michael author non-byline.; Dhaliwal Kiran author non-byline.; Fenner Christopher author non-byline.; Gillard Jordan author non-byline.; Glancy Laurie author non-byline.; Goodhart Gavin author non-byline.; Hammond Lara author non-byline.; Harrington Tony author non-byline.; Hinchliffe Rob author non-byline.; Holt Peter author non-byline.; Hughes Cian author non-byline.; Janakan Gnananandan author non-byline.; Jarman Heather author non-byline.; King Harry author non-byline.; MacDonald Ian author non-byline.; Mannes Laura author non-byline.; Maynard Sheraz Marker William author non-byline.; Mongue-Din Heloise author non-byline.; Moore Fiona author non-byline.; Nash Mark author non-byline.; Oladokun Dare author non-byline.; Palmer Jasmine author non-byline.; Parry Ryan author non-byline.; Patel Kiran author non-byline.; Patel Shaneel author non-byline.; Patterson Benjamin author non-byline.; Phillips Stephen author non-byline.; Poloniecki Jan author non-byline.; Qureshi Mahim author non-byline.; Rankin Lucy author non-byline.; Smith Adam author non-byline.; Speak James author non-byline.; Thompson Matt author non-byline.; Vidal-Diez Alberto author non-byline.; Whitbread Mark author non-byline.; White Mark author non-byline.;
• Is Part Of: BMJ open. Volume 6:Issue 10(2016)
• Publication Date: 2016-10-24
• Subjects: smartphone -- mobile app -- pre-hospital -- ruptured abdominal aortic aneurysm -- VASCULAR SURGERY; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2016-011308
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre. Methods and analysis: Prospective multicentre observational study assessing the diagnostic accuracy of a prehospital smartphone triage tool for detection of rAAA. The study will be conducted across London in conjunction with London Ambulance Service (LAS). A logistic score predicting the risk of rAAA by assessing ten key parameters was developed and retrospectively validated through logistic regression analysis of ambulance records and Hospital Episode Statistics data for 2200 patients from 2005 to 2010. The triage tool is integrated into a secure mobile app for major smartphone platforms. Key parameters collected from the app will be retrospectively matched with final hospital discharge diagnosis for each patient encounter. The primary outcome is to assess the sensitivity, specificity and positive predictive value of the rAAA triage tool logistic score in prospective use as a mob app for prehospital ambulance clinicians. Data collection started in November 2014 and the study will recruit a minimum of 1150 non-consecutive patients over a time period of 2 years. Ethics and dissemination: Full ethical approval has been gained for this study. The results of this study will be disseminated in peer-reviewed publications, and international/national presentations. Trial registration number: CPMS 16459; pre-results.