Transitions, Risks, and Actions in Coronary Events--Center for Outcomes Research and Education (TRACE-CORE): design
Molly E Waring1, Richard H McManus, Jane S Saczynski
1Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA. molly.waring@umassmed.edu
Insights
The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) study examines acute coronary syndromes. It aims to improve patient transitions from hospital to community, reducing mortality and enhancing quality of life.
Area of Science:
- Cardiovascular disease outcomes research
- Health services research
- Clinical epidemiology
Background:
- Cardiovascular disease significantly impacts morbidity, mortality, and quality of life.
- Underuse of evidence-based practices limits health gains.
- The TRACE-CORE initiative addresses acute coronary syndromes (ACS).
Purpose of the Study:
- To examine determinants and outcomes of hospital-to-community transition quality in ACS patients.
- To quantify the impact of modifiable factors on quality of life, rehospitalization, and mortality.
- To develop and validate predictive action scores for recurrent cardiac events and mortality.
Main Methods:
- Longitudinal, multiracial cohort study of 2500 ACS patients across 6 US hospitals.
- 24-month follow-up including medical record abstraction and patient interviews.
- Development of action scores to predict outcomes and a patient/provider dashboard.
Main Results:
- Currently enrolling patients for a comprehensive longitudinal study.
- Focus on modifiable factors influencing patient transitions and outcomes.
- Anticipates development of predictive scores for cardiac events and mortality.
Conclusions:
- TRACE-CORE integrates observational study principles with outcomes and effectiveness research.
- Expected to inform novel secondary prevention strategies for cardiovascular disease.
- Aims to foster the careers of cardiovascular outcomes researchers.
Background:
Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality.
Methods And Results:
TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, and development of a nucleus of early stage investigators. We are currently enrolling 2500 adults hospitalized for acute coronary syndromes at 6 hospitals in the northeastern and southeastern United States. We will follow these patients for 24 months after hospitalization through medical record abstraction and 5 patient interviews focusing on quality of life, cardiac events, rehospitalizations, mortality, and medical, behavioral, and psychosocial characteristics. The Transitions Project studies determinants of and disparities in outcomes of the quality of patients' transition from hospital to community. Focusing on potentially modifiable factors, the Action Scores Project will develop and validate action scores to predict recurrent cardiac events, death, and quality of life, describe longitudinal variation in these scores, and develop a dashboard for patient and provider action on the basis of these scores.
Conclusions:
In TRACE-CORE, sound methodologic principles of observational studies converge with outcomes and effectiveness research approaches. We expect that our data, research infrastructure, and research projects will inform the development of novel secondary prevention approaches and underpin the careers of cardiovascular outcomes researchers.
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