Patients with heart attacks or other acute heart events may receive better care and have lower death rates in hospitals that take part in clinical trials, U.S. researchers report.
They analyzed data on more than 174,000 patients with two types of heart conditions -- high-risk non-ST-segment elevation acute coronary syndrome with unstable angina and non-ST-segment elevation myocardial infarction (heart attack).
Some recent studies suggest that physician leadership, shared team goals, administrative support and credible feedback are associated with better hospital performance. It's believed that some of these same characteristics are also important in successful hospital-based clinical trials, according to background information in the study.
"We hypothesized that these same elements required for hospitals to participate in trials could induce beneficial changes in the hospital environment, thereby leading to better processes and outcomes of care for patients treated outside the trial setting," wrote Dr. Sumit R. Majumdar, of the University of Alberta in Canada, and colleagues.
Majumdar and colleagues divided the patients treated at 494 hospitals into three groups: those treated at hospitals that didn't participate in clinical trials (29,984), hospitals with low trial participation (93,705), and hospitals with high trial participation (50,373). In total, 4,590 of the patients were enrolled in clinical trials.
"In-hospital mortality decreased with increasing trial participation: 5.9 percent vs. 4.4 percent vs. 3.5 percent," the study authors wrote. "Patients treated at hospitals that participated in trials had significantly lower mortality than patients treated at non-participating hospitals."
The study was published in the March 24 issue of the journal Archives of Internal Medicine.
"In conclusion, patients treated at hospitals that participate in clinical trials seem to receive better quality of care and seem to have significantly better outcomes than patients treated at hospitals that do not participate in trials -- at least in the setting of acute coronary syndrome," the researchers wrote. "For policy makers and physicians, our findings should assuage some of the concerns related to the possible opportunity costs and potential downsides of participating in the clinical research enterprise."
More information
The American Heart Association outlines heart attack treatments.
SOURCE: JAMA/Archives journals, news release, March 24, 2008
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