Appendix 9ES (Information Resources, 5% for 6 months) will supervise systematic <strong>review</strong>ing.DN (University <strong>of</strong> Edinburgh, Cardiology, 2% for 15 months) <strong>and</strong> ST (University <strong>of</strong> Sheffield, VascularRadiology, 2% for 15 months) will provide cardiology <strong>and</strong> vascular radiology expert input.FM, JK <strong>and</strong> PC will provide emergency medicine <strong>and</strong> chemical pathology expertise, but will be fundedthrough NIHR NHS support.Other expenses will include:• z Computing equipment, including licences for systematic <strong>review</strong> <strong>and</strong> decision <strong>analysis</strong>s<strong>of</strong>tware = £1250.• z Information resources support: literature searches, document retrieval, photocopying = £3000• z Office expenses for the research team @ £1,500 per wte per year (total 2.5 wte years) = £4687• z Travel for the expert panel <strong>and</strong> project management group, £2000, <strong>and</strong> for conference attendance,£1000.The University <strong>of</strong> Sheffield has joined phase 3 <strong>of</strong> the Carbon Trust’s Higher Education CarbonManagement Programme. This programme is designed to deliver improved energy management <strong>of</strong>academic, accommodation <strong>and</strong> leisure buildings <strong>and</strong> vehicle fleets. It also provides practical support toorganisations by helping them identify carbon saving opportunities, providing s<strong>of</strong>tware to analyse energyconsumption <strong>and</strong> delivering workshop support for staff <strong>and</strong> senior managers to improve their awareness<strong>of</strong> energy efficiency.Our proposal is a secondary research project that will be largely undertaken in a single centre, sogreenhouse gas emissions directly related to the project will be relatively small. Indeed, this is anotheradvantage <strong>of</strong> using <strong>modelling</strong> techniques. We will further minimise emissions by:1. conducting project management <strong>and</strong> expert panel meetings by teleconference where possible2. conducting meetings in a central location that is accessible by public transport3. disseminating findings using electronic media where possible4. using public transport to travel to conferencesReferences1. National Clinical Guidelines Centre for Acute <strong>and</strong> Chronic Conditions. Chest pain <strong>of</strong> recent onset:assessment <strong>and</strong> investigation <strong>of</strong> recent onset chest pain or discomfort <strong>of</strong> suspected cardiac origin.Full Guideline – Consultation Version, 13 May 2009.2. The National Service for Coronary Heart Disease. Department <strong>of</strong> Health, 2000. London.3. Goldberg RJ, Currie K, White K, Brieger D, Steg PG, Goodman SG, Dabbous O, Fox KA, Gore JM.Six-month outcomes in a multinational registry <strong>of</strong> patients hospitalized with an acute coronarysyndrome (the Global Registry <strong>of</strong> Acute Coronary Events [GRACE]). Am J Cardiol 2004;93:288–93.4. Goodacre S, Cross E, Arnold J, Angelini K, Capewell S, Nicholl J. The health care burden <strong>of</strong> acutechest pain. Heart 2005;91:229–230.5. Thygesen K, Alpert JS, White HD; Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition<strong>of</strong> Myocardial Infarction. Universal definition <strong>of</strong> myocardial infarction. J Am Coll Cardiol2007;50(22):2173–95.6. Ebell MH, Flewelling D, Flynn CA. A systematic <strong>review</strong> <strong>of</strong> troponin T <strong>and</strong> I for diagnosing acutemyocardial infarction. J Fam Pract 2000;49:550–56.186NIHR Journals Library
DOI: 10.3310/hta17010 Health Technology Assessment 2013 Vol. 17 No. 17. Ebell MH, White LL, Weismantel D. A systematic <strong>review</strong> <strong>of</strong> troponin T <strong>and</strong> I values as a prognostictool for patients with chest pain. J Fam Pract 2000;49:746–53.8. Hamm CW, Heeschen C, Goldmann B, et al. Benefit <strong>of</strong> abciximab in patients with refractoryunstable angina in relation to serum troponin T levels. N Engl J Med 1999;340:1623–99. Balk EM, Ioannidis JPA, Salem D, Chew PW, Lau J. Accuracy <strong>of</strong> cardiac biomarkers to diagnoseacute cardiac ischaemia in the emergency department: a <strong>meta</strong>-<strong>analysis</strong>. Ann Emerg Med2001;37:478–94.10. Mitchell AM, Brown MD, Menown IBA, Kline JA. Novel protein markers <strong>of</strong> acute coronary syndromecomplications in low-risk outpatients: a systematic <strong>review</strong> <strong>of</strong> potential use in the emergencydepartment. Clinical Chemistry 2005;51:2005–11.11. Goodacre S & Calvert N. Cost effectiveness <strong>of</strong> diagnostic strategies for patients with acute,undifferentiated chest pain. Emerg Med J 2003;20:429–33.12. Mant J, McManus RJ, Oakes RAL, Delaney BC, Barton PM, Deeks JJ, Hammersley L, et al. <strong>Systematic</strong><strong>review</strong> <strong>and</strong> <strong>modelling</strong> <strong>of</strong> the investigation <strong>of</strong> acute <strong>and</strong> chronic chest pain presenting in primarycare. Health Technol Assess 2004;8(2).13. Choi YF, Wong TW, Lau CC. The diagnostic value <strong>and</strong> cost effectiveness <strong>of</strong> creatine kinase-MB,myoglobin <strong>and</strong> cardiac troponin-T for patients with chest pain in emergency departmentobservation ward. Hong Kong Journal <strong>of</strong> Emergency Medicine 2004;11:85–90.14. Zarich S, Bradley K, Seymour J, Ghali W, et al. Impact <strong>of</strong> troponin T determinations on hospitalresource utilization <strong>and</strong> costs in the evaluation <strong>of</strong> patients with suspected myocardial ischemia.Am J Cardiol 2001;88:732–6.15. Task Force on the Management <strong>of</strong> Acute Coronary Syndromes <strong>of</strong> the European Society forCardiology. Management <strong>of</strong> acute coronary syndromes in patients presenting without ST elevation.Eur Heart J 2002;23:1809–40.16. Mowatt G, Cummins E, Waugh N, et al. <strong>Systematic</strong> <strong>review</strong> <strong>of</strong> the clinical effectiveness <strong>and</strong> costeffectiveness<strong>of</strong> 64-slice or higher computed tomography angiography as an alternative to invasivecoronary angiography in the investigation <strong>of</strong> coronary artery disease. Health Technol Assess2008;12(17).17. H<strong>of</strong>fmann U, Nagurney JT, Moselewski F, Pena A, et al. Coronary multidetector computedtomography in the assessment <strong>of</strong> patients with acute chest pain. Circulation 2006;114:2251–60.18. Coles DR, Wilde P, Oberh<strong>of</strong>f M, Rogers CA, et al. Multislice computed tomography coronaryangiography in patients admitted with a suspected acute coronary syndrome. Int J CardiovascImaging 2007;23:603–14.19. Johnson TR, Nikolaou K, Wintersperger BJ, Knez A, et al. ECG-gated 64-MDCT angiography in thedifferential diagnosis <strong>of</strong> acute chest pain. AJR Am J Roentgenol 2007;188:76–82.20. Rubinshtein R, Halon DA, Gaspar T, Jaffe R, et al. Usefulness <strong>of</strong> 64-slice cardiac computedtomographic angiography for diagnosing acute coronary syndromes <strong>and</strong> predicting clinicaloutcome in emergency department patients with chest pain <strong>of</strong> uncertain origin. Circulation2007;115:1762–8.21. Ladapo JA, H<strong>of</strong>fmann U, Bamberg F, Nagurney JT, et al. Cost effectiveness <strong>of</strong> coronary MDCT in thetriage <strong>of</strong> patients with acute chest pain. AJR Am J Roentgenol 2009;191:455–63.22. Khare RK, Courtney DM, Powell ES, Venkatesh AK, et al. Sixty-four slice computed tomography<strong>of</strong> the coronary arteries: cost effectiveness <strong>analysis</strong> <strong>of</strong> patients presenting to the emergencydepartment with low-risk chest pain. Acad Emerg Med 2008;15:623–32.© Queen’s Printer <strong>and</strong> Controller <strong>of</strong> HMSO 2013. This work was produced by Goodacre et al. under the terms <strong>of</strong> a commissioning contract issued by the Secretary <strong>of</strong> Statefor Health. This issue may be freely reproduced for the purposes <strong>of</strong> private research <strong>and</strong> study <strong>and</strong> extracts (or indeed, the full report) may be included in pr<strong>of</strong>essional journalsprovided that suitable acknowledgement is made <strong>and</strong> the reproduction is not associated with any form <strong>of</strong> advertising. Applications for commercial reproduction should beaddressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials <strong>and</strong> Studies Coordinating Centre, Alpha House, University <strong>of</strong> Southampton SciencePark, Southampton SO16 7NS, UK.187
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