The safety and efficacy of implementing the PreHEART decision support tool by the Emergency Medical Service for patients with undifferentiated chest pain: a prospective randomized open blinded end-point study (PreHeart-3 study)

Decisions on (non-)conveyance of patients are challenging for the ambulance personnel (emergency medical services [EMS]). The majority (>75%) of patients presenting with undifferentiated chest pain (or discomfort) is conveyed to the nearest hospital. Improving pre-hospital assessment of patients with undifferentiated chest pain may improve safety, optimize the efficacy of care, and reduce health-related costs.
Observational data in patients conveyed to the hospital suggests that our recently developed pre-hospital HEART (preHEART) risk score represents a reliable tool to identify individuals at very low risk (±38% of patients), low-intermediate (±5%) and very high risk (±7%) of severe cardiovascular pathology requiring urgent care. Whether adding this decision support tool in clinical practice to support the decision-making process on (non-)conveyance by the ambulance personnel is safe and more.

The PreHEART score supports EMS staff in their decision to convey a patient with undifferentiated chest pain and increases the non-conveyance up to 20%, which leads to fewer presentations to an ED.

3 days, 3 and 12 month

The PreHEART is available to a randomized patient whose risk of an ACS has been assessed. The decision to convey can be guided by the preHEART score which suggestion to non-convey for patients with a very low risk of ACS, or convey patients with intermediate risk to the nearest hospital, or convey a patient to a hospital with PCI facilities.