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The Center for Cardiovascular Health Services Research (CCHSR), directed by Dr. Selker, is known for a series of studies on the factors influencing emergency cardiac care and over the past two decades, the development of "cardiac predictive instruments" for use in the emergency cardiac clinical setting. These decision aids, which provide the emergency physician with predictions of key outcomes, are incorporated into a standard computerized electrocardiograph. These decision aids have been the subject of multicenter clinical trials run by the CCHSR in recent years, including a 10,700-subject national trial in 10 hospitals of the acute ischemia instrument, a 28-hospital trial of the thrombolytic predictive instrument (TPI), and an emergency medical service (EMS) system-based clinical trial of the use of electrocardiograph-based instruments in ambulances.
<p>
In developing these cardiac predictive instruments, the CCHSR pioneered the development of "time-insensitive predictive instruments" (TIPIs), which can be used both for real-time emergency care and also for retrospective review of care. Given that the use of the same, clinically relevant, outcome measures by physicians, hospitals, payors, and agencies, can help coordinate care, TIPIs have vast implications for the improvement of healthcare delivery.
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