Top Things to Know: Key Data Elements and Definitions for ACS and CAD

The key elements and definitions presented here are a compilation of variables intended to

• facilitate the consistent, accurate, and reproducible capture of clinical concepts;
• standardize terminology used to describe cardiovascular diseases and procedures;
• create a data environment conducive to the assessment of patient management and outcomes for quality and performance improvement and clinical and translational research; and
• increase opportunities for sharing data across disparate data sources.

Data elements and definitions were developed in seven categories:

1. Demographic and admission – demographic elements intended to be collected only once; admission information to describe status of care and provide the initial elements to articulate patient risk and the impact of risk on the entire episode of care and its outcomes.
2. History and risk factors – assessment of cardiovascular and general medical history necessary for assessing risk and understanding of variations in outcome. The information is also critical in applying results to quality improvement efforts and for comparison with clinical trial results.
3. Clinical presentation – includes presenting symptoms and vital statistics along with the presence of biomarkers are key indicators for defining the patient with ACS.
4. Diagnostic procedure – data elements for classifying type of MI based on ECG are included as well as data elements to track the date, time, and location of the first ECG as it is becoming more common for EMS to conduct ECG in the field.
5. Invasive therapeutic intervention – covers noninvasive stress testing, evaluation of maximum stenosis percent narrowing in the major epicardial systems, assessment of left ventricular ejection fraction and the modality, and results of diagnostic coronary angiography if performed.
6. Medication – important dimensions of medication administration included are type of agent used, timing, dosage, duration, and contraindications.
7. Outcomes – data elements are included to capture details on in-hospital events, recurrent events, and discharge status which are essential in determining the efficacy of therapies.