This trial will prospectively evaluate the impact of integrating AI-ECG within the pay-for-performance program on improving the diagnosis, treatment, and clinical outcomes of occlusion myocardial infarction patients by promoting accurate and timely diagnoses through financial incentives.
The investigators have developed an AI-ECG system that provides real-time notifications for patients with potential occlusion myocardial infarction. This AI algorithm is seamlessly integrated into the Hospital Information System, allowing for the automatic generation of reports whenever an ECG is performed. The purpose of this study is to evaluate the impact of AI-ECG on the timely diagnosis of STEMI, including patients' outcomes and healthcare costs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
212,000
The AI-ECG system will conduct a real-time analysis of the ECG. When the system identifies potential OMI cases, it will immediately send short message service notifications to the on-duty cardiologists. This will enable the cardiologists to promptly review and confirm the diagnosis.
Kaohsiung Armed Forces General Hospital
Kaohsiung City, Taiwan, Taiwan
RECRUITINGTaipei Municipal Wanfang Hospital
Taipei, Taiwan
RECRUITINGTri-Service General Hospital
Taipei, Taiwan
RECRUITINGD-to-W time (Door to Wire Time)
Door-to-wire time refers to the duration from a patient's arrival at the emergency department (ED) to the successful placement of a wire into the coronary artery during a primary percutaneous coronary intervention (PPCI) procedure.
Time frame: From the start of the emergency visit to the following 48 hours.
Cost Outcome Measure
Total expenditures, from the start of the emergency visit to 90 days post-discharge (in USD), for comparison between the intervention and control groups, based on records from NHI (National Health Insurance) claims data.
Time frame: From the start of the emergency visit to 90 days post-discharge.
Door-to-Wire time less than 90 minutes
The proportion of patients achieving a Door-to-Wire time of less than 90 minutes in the intervention group compared to the control group. The intervention and control groups' door-to-wire time will be compared. Door-to-wire time is defined as the duration from the first ECG to the successful placement of the wire during PPCI for OMI patients in the emergent department.
Time frame: 48 hours
In-hospital all-cause Mortality Rate
The proportion of patients who die from any cause, regardless of the underlying condition, during hospitalization.
Time frame: 90-day follow
In-hospital cardiac death
The proportion of patients who die from cardiovascular-related causes during hospitalization.
Time frame: 90-day follow
Length of ICU
Comparison of length of ICU between the intervention and control groups.
Time frame: 90-day follow
Length of hospitalization
Comparison of length of hospitalization between the intervention and control groups.
Time frame: 90-day follow
Cardiovascular events
Composite cardiovascular events (Non-fatal MI + Non-fatal stroke + CV Death) The rate of composite cardiovascular events within 90 days.
Time frame: 90-day follow
Non-fatal MI
The rate of non-fatal MI within 90-days.
Time frame: 90-day follow
Non-fatal stroke (Ischemic stroke + Hemorrhagic stroke)
The rate of non-fatal strokes (both ischemic and hemorrhagic) within 90-days.
Time frame: 90-day follow
Cardiac Death
The proportion of patients who die from cardiovascular-related causes within 90-days.
Time frame: 90-day follow
Ischemic stroke
The incidence of ischemic stroke.
Time frame: 90-day follow
Hemorrhagic stroke
The incidence of hemorrhagic stroke.
Time frame: 90-day follow
All-cause mortality
The proportion of patients who die from any cause within 90-days.
Time frame: 90-day follow
Coronary artery bypass grafting (CABG)
The rate of patients who undergo coronary artery bypass surgery (CABG) within 90-days following OMI treatment.
Time frame: 90-day follow
Heart failure admission
The rate of hospital admissions for heart failure within 90-days following OMI treatment.
Time frame: 90-day follow
Re-hospitalization (from any cause)
The rate of readmission to the hospital within 90-days of discharge.
Time frame: 90-day follow
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