Picture the scene…
You are assessing a patient with low risk chest pain and wonder if one high sensitivity troponin will be enough to rule out a cardiac cause…
To critically appraise the LoDED Study
Task 1 – Read the Paper
Read and critically appraise the paper – “Randomised controlled trial of the Limit of Detection of Troponin and ECG Discharge (LoDED) strategy versus usual care in adult patients with chest pain attending the emergency department: study protocol1“.
You might find this SGEM/BEEM checklist for Diagnostic studies useful.
Task 2 – Listen
Listen to lead author Edd Carleton discuss the study and what we can take into practice. The interview is taken from an RCEM Learning podcast for June 2020.
Task 3 – Discuss
This part of the teaching session should be lead by an experienced clinician.
Go through the SGEM/BEEM Critical Appraisal checklist. Discuss any points that learners disagree on.
How will this paper change your practice (or won’t it?) What could the researchers do to extend this research?
Task 4 – Summary
In this session we have critically appraised a paper about the use of high sensitivity troponin for the assessment of the patient with low risk chest pain.
Task 5 – Reflect
In order to embed today’s learning further, reflect on what you have learnt and record in your portfolio whether it has had any impact (or is expected to have any impact) on your performance and practice.
Was this a topic that you were confident you knew already? Which parts were new to you? Were there elements that you will use on your next clinical shift.
Dscuss this session with your colleagues – were there people who missed it who you can share the highlights with?
- 1Carlton E, Campbell S, Ingram J, et al. Randomised controlled trial of the Limit of Detection of Troponin and ECG Discharge (LoDED) strategy versus usual care in adult patients with chest pain attending the emergency department: study protocol. BMJ Open 2018; : e025339.