Accelerating the diagnosis of ACS in Aboriginal and Torres Strait Islander patients
In emergency departments (EDs), the faster Acute Coronary Syndrome (ACS)* is diagnosed, the better the outcomes for the patient. A Queensland research team is investigating an accelerated blood testing diagnosis protocol with Aboriginal and Torres Strait Islander people to help doctors assess if patients are high, intermediate or low risk of ACS.
The research team is a collaboration of investigators from Cairns and Brisbane, supported by Professor Louise Cullen. The team are collecting data at the Cairns Hospital ED where approximately a quarter of patients who present with symptoms of suspected ACS, such as chest pain, identify as Aboriginal and/or Torres Strait Islander. Establishing if a patient is high or low risk of ACS will help assess patients safely and efficiently in the ED ensuring timely cardiac testing and appropriate utilisation of clinical resources.
Aboriginal and Torres Strait Islander people and representative groups have collaborated with the research team to co-design the project in a culturally sensitive way. The team has run several community engagement sessions with Aboriginal and Torres Strait Islander community elders, clinical staff that identify as Aboriginal and Torres Strait Islander people, community and cultural advisors. Local Aboriginal Community Controlled Health Services also provided critical feedback on the referral and follow-up process for patients taking part in the research project. The research team will continue to engage with community to ensure the research findings are shared openly to benefit Aboriginal and Torres Strait Islander people.
Almost 300 people have now participated in this research project. The initial results show that it is appropriate to treat Aboriginal and Torres Strait Islander people presenting to emergency with ACS symptoms as intermediate to high-risk patients. The research trial has also achieved a 99 per cent follow up rate for cardiac outcomes.
This project is an example of Queensland research teams drawing on their combined experience across regional and metropolitan health services and supporting each other to build research capacity and overcome ethics and contracting challenges.
The project received funding through the Federal Government’s Rapid Applied Research Translation (RART) initiative to help translate its research findings into clinical practice.
*ACS is an umbrella term used to describe a range of conditions associated with sudden, reduced blood flow to the heart, e.g., a heart attack.