Woman and Man
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Extract
Background and study aims Heart failure is caused by the heart muscle becoming weak or stiff and failing to pump enough blood around the body. It significantly reduces quality of life and life expectancy. The costs to the NHS are high due to frequent hospitalisation and GP visits. Heart failure is a common problem in primary care, but diagnosis is difficult and GPs must decide which patients need further tests. Heart failure can be diagnosed by ultrasound (an echocardiogram) but it is expensive and limited. Therefore, GPs rely on less effective tests, resulting in under-diagnosis. Accurate diagnosis, appropriate treatment and cost−effective use of NHS resources are needed to improve quality of life and life expectancy. However, there is uncertainty in these areas. We aim to find out if a clinical decision rule (CDR) can help GPs determine which patients should be referred for an echocardiogram and if it is cost−effective. The study will tell us if a simple rule involving symptoms, physical examination and blood testing can be used for better diagnosis and targeting of further diagnostic tests for heart failure, helping to improve quality of care and save money. Who can participate? Patients aged 55 or over visiting their GP with new symptoms of breathlessness, lethargy (tiredness) or ankle oedema (swelling) What does the study involve? The GP refers all patients for chest x−ray (as usual), and then to a central research clinic. Information on symptoms and quality of life are collected, and patients undergo an electrocardiogram (measuring the electrical activity of the heart), an echocardiogram (an ultrasound scan of the heart), and provide a blood sample. We want to find out whether the CDR can correctly identify all cases with heart failure. We follow-up patients after 6 and12 months to collect medical and quality of life information. What are the possible benefits and risks of participating? Not provided at time of registration Where is the study run from? University of Oxford (UK) When is the study starting and how long is it expected to run for? April 2011 to June 2014 Who is funding the study? Medical Research Council (MRC)/National Institute of Health Research (NIHR) (UK) - Efficacy and Mechanism Evaluation (EME) Programme (UK) Who is the main contact? Prof Richard Hobbs
Inclusion criteria
- Heart failure