Health Services and Economic Impacts of the Limit of Detection in Emergency Department (LEGEND) Rule-Out Strategy in Australian Emergency Departments: A Stepped-Wedge Cluster Randomised Trial.

ABSTRACT:

Objective

This study aimed to describe healthcare utilisation and costs associated with the assessment of suspected acute coronary syndrome (ACS) under standard care and to compare these outcomes with the Limit of Detection in Emergency Department (LEGEND) strategy, an accelerated diagnostic pathway identifying low-risk patients using a single highly sensitive troponin (hs-cTnI).

Method

A stepped-wedge cluster randomised trial was conducted in four Queensland hospitals. Each transitioned from standard care (2016 ACS guidelines) to the LEGEND intervention at randomised intervals. Data were collected for index presentations and 6-month outcomes.

Results

Data were collected from 5347 patients in the standard care phase and 4597 in the LEGEND intervention phase. The inter

SUBMITTER: Dobson O 

PROVIDER: S-EPMC12402291 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature