John W. Pickering
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Analytical Verification of a Point-of-Care High-Sensitivity Troponin I Assay Open
Background The QuidelOrtho TriageTrue® point-of-care (POC) high-sensitivity troponin I (hs-TnI) assay has been previously validated. We aimed to independently verify the assay’s analytical performance and concordance with other assays and …
View article: Soluble urokinase plasminogen activator receptor (suPAR) for risk stratification from undifferentiated acute chest pain through to convalescence after acute coronary syndromes
Soluble urokinase plasminogen activator receptor (suPAR) for risk stratification from undifferentiated acute chest pain through to convalescence after acute coronary syndromes Open
Aim The performance of plasma soluble urokinase plasminogen activator receptor (suPAR) for prediction of heart failure (HF) readmission or death within 5 years was assessed in patients incurring (i) initially undifferentiated chest pain an…
View article: Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process
Improving Emergency Department Prescribing of Anticoagulation for Atrial Fibrillation Through an Iterative Quality Improvement Process Open
Objective To assess the impact of two iterations of an emergency department (ED) atrial fibrillation (AF) pathway on anticoagulant prescribing. Methods Two quality improvement projects gave targeted anticoagulation guidance for AF. Anticoa…
Extensive weight loss prior to bariatric surgery is associated with worse outcomes Open
Background: Weight loss has been shown to favorably affect obesity-related comorbid disease. Prior studies have shown that a 10% preoperative weight loss is associated with fewer complications after gastric bypass surgery. Although the opt…
Reimagining the Vividness of Visual Imagery Questionnaire as a single-item screener for aphantasia Open
Despite criticism, the Vividness of Visual Imagery Questionnaire (VVIQ) has emerged as the gold standard for identifying visual aphantasia (i.e., the absence or stark reduction of visual imagery). While more comprehensive measures are need…
View article: Atrial fibrillation patients presenting to an emergency department successfully managed with a next‐day community follow‐up pathway: A before‐and‐after cohort study
Atrial fibrillation patients presenting to an emergency department successfully managed with a next‐day community follow‐up pathway: A before‐and‐after cohort study Open
Objectives To assess the effectiveness and safety of the new clinical pathway for patients presenting to an ED with AF, incorporating community next‐working‐day follow‐up and more specific clinician guidance around medication prescribing. …
Evaluation of a virtual emergency care service to avoid unnecessary emergency department presentations and provide specialist‐led definitive care Open
Objective A quantitative and qualitative evaluation of the impact of a peer‐to‐peer telehealth service called Specialist Telehealth Aotearoa (STAR) on transfers to the ED. Methods This mixed‐methods study reviewed STAR between 31 July 2023…
Mild and moderate traumatic brain injury: Screening, documentation, and referral to concussion services Open
Better documentation of mild/moderate TBI might facilitate health care access, with efficient clinical decision making.
Potential length of stay reductions from emergency department use of a point‐of‐care high‐sensitivity cardiac troponin assay: Pilot findings from Australia's first cardiac emergency department Open
Objective To compare actual ED length of stay (LOS) using laboratory‐based high‐sensitivity cardiac troponin I (hs‐cTnI) testing with the potential LOS that could result from using point‐of‐care (POC) hs‐cTnI tests. Methods Baseline hs‐cTn…
View article: Effect of change of high‐sensitivity troponin <scp>I</scp> assay on emergency department diagnosis and disposition of patients with possible acute coronary syndrome
Effect of change of high‐sensitivity troponin <span>I</span> assay on emergency department diagnosis and disposition of patients with possible acute coronary syndrome Open
Objective Changing cardiac troponin (cTn) assays may affect a hospital's admission and myocardial infarction rates. The effect of changing from a contemporary to high‐sensitivity (hs) cTnI assay has been well described, but the real‐life i…
View article: Insulin-like growth factor binding protein-3 (IGFBP-3): a biomarker of coronary artery disease induced myocardial ischaemia
Insulin-like growth factor binding protein-3 (IGFBP-3): a biomarker of coronary artery disease induced myocardial ischaemia Open
Aims Among individuals presenting to the emergency department (ED) with chest pain, clinical uncertainty surrounds the appropriate identification of non-myocardial infarction (MI) individuals who would most benefit from objective functiona…
View article: Clinical derivation and data simulated validation of rule-out and rule-in algorithms for the Siemens Atellica IM high-sensitivity cardiac troponin I assay
Clinical derivation and data simulated validation of rule-out and rule-in algorithms for the Siemens Atellica IM high-sensitivity cardiac troponin I assay Open
Aims This prospective, two-centre study derived and validated predictive algorithms for the Siemens Atellica IM high-sensitivity cardiac troponin I (hs-cTnI) assay in the emergency department (ED). Methods and results Algorithms for predic…
Emergency department use of a high-sensitivity point-of-care troponin assay reduces length of stay: an implementation study preliminary report Open
Aims Point-of-care (POC) high-sensitivity troponin (hs-cTn) assays within a clinical pathway may safely reduce length of stay (LoS) for patients presenting to the emergency department (ED) with possible acute myocardial infarction (AMI). I…
The use of a point of care high sensitivity troponin in the investigation of patients presenting to the Emergency Department with undifferentiated chest pain Open
Background In 2012 in a hospital, New Zealand, a chest pain pathway was instituted for the use in patients presenting to the Emergency Department (ED) with undifferentiated chest pain. This reduced hospital admissions and ED length of stay…
Analytical verification of the Atellica VTLi point of care high sensitivity troponin I assay Open
Objectives The Siemens Point-of-Care Testing (POC) Atellica ® VTLi high-sensitivity troponin I (hsTnI) device has been previously validated. Verification independently provides evidence that an analytical procedure fulfils concordance with…
View article: Protocol for Improving Care by FAster risk-STratification through use of high sensitivity point-of-care troponin in patients presenting with possible acute coronary syndrome in the EmeRgency department (ICare-FASTER): a stepped-wedge cluster randomised quality improvement initiative
Protocol for Improving Care by FAster risk-STratification through use of high sensitivity point-of-care troponin in patients presenting with possible acute coronary syndrome in the EmeRgency department (ICare-FASTER): a stepped-wedge cluster randomised quality improvement initiative Open
Introduction Clinical assessment in emergency departments (EDs) for possible acute myocardial infarction (AMI) requires at least one cardiac troponin (cTn) blood test. The turn-around time from blood draw to posting results in the clinical…
Determination of Clinically Acceptable Analytical Variation of Cardiac Troponin at Decision Thresholds Open
Background Clinical decision-making for risk stratification for possible myocardial infarction (MI) uses high-sensitivity cardiac troponin (hs-cTn) thresholds that range from the limit of detection to several-fold higher than the upper ref…
Prognostic performance of soluble urokinase plasminogen activator receptor for heart failure or mortality in Western and Asian patients with acute breathlessness Open
suPAR is a strong independent predictor of HF and/or death at 1 year in acutely breathless patients, in both Asian and Western cohorts, and in HF. suPAR may improve stratification of acutely breathless patients, and in acute HF, for risk o…
Convalescent Growth Differentiation Factor-15 and Long-Term Outcomes after an Acute Coronary Syndrome Open
Background Growth differentiation factor-15 (GDF-15) has been shown to be associated with adverse clinical outcomes in patients after an acute coronary syndrome when measured soon after an event. Although dynamic in the acute phase after m…
View article: Derivation and Validation of Thresholds Using Synthetic Data Methods for Single-Test Screening of Emergency Department Patients with Possible Acute Myocardial Infarction Using a Point-of-Care Troponin Assay
Derivation and Validation of Thresholds Using Synthetic Data Methods for Single-Test Screening of Emergency Department Patients with Possible Acute Myocardial Infarction Using a Point-of-Care Troponin Assay Open
Background Single-sample (screening) rule-out of acute myocardial infarction (AMI) with troponin requires derivation of a single-test screening threshold. In data sets with small event numbers, the lowest one or two concentrations of myoca…
The Drug Burden Index and Level of Frailty as Determinants of Healthcare Costs in a Cohort of Older Frail Adults in New Zealand Open
With no relationship found between a patient's anticholinergic and sedative medication burden and their total healthcare costs, more research is required to understand how and where to unlock healthcare cost savings within frail, older pop…
Comparison of three creatinine-based equations to predict adverse outcome in a cardiovascular high-risk cohort: an investigation using the SPRINT research materials Open
Background Novel creatinine-based equations have recently been proposed but their predictive performance for cardiovascular outcomes in participants at high cardiovascular risk in comparison to the established CKD-EPI 2009 equation is unkn…
Assay of macrotroponin I not complexed with troponin T: effect on the performance of troponin T to predict myocardial infarction Open
Background Cardiac troponin-immunoglobulin (Ig) complexes (macrotroponin) can interfere with cardiac troponin (cTn) test performance. However, the role of this interference has not been fully explored. We developed a specific, novel, 2-hou…
Association of left ventricular geometry early after an acute coronary syndrome to long-term mortality Open
Background Markers of adverse left ventricular remodelling following myocardial infarction are associated with an increased risk of adverse events. Remodelling patterns can be classified using left ventricular mass index (LVMI) and relativ…