Ambulance smartphone tool for field triage of ruptured aortic aneurysms (FILTR): study protocol for a prospective observational validation of diagnostic accuracy
Lewis, Thomas L. Aneurysm-FILTR Study Group Karthikesalingam, Alan
Lewis, Thomas L.
Aneurysm-FILTR Study Group
Karthikesalingam, Alan
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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
https://bmjopen.bmj.com/content/6/10/e011308.long
This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
http://dx.doi.org/10.1136/bmjopen-2016-011308