Abstract 11467: Novel Identification Strategy to Increase Diversity in Heart Failure Clinical Trials

Abstract

Introduction: Women and racial/ethnic minorities remain underrepresented in cardiovascular (CV) clinical trials, thus limiting the generalizability of study findings and the use of novel CV therapeutic testing among those who often have the greatest burden of CV disease. One potential solution is to shift the identification of trial participants from traditional academic centers to large registries. To this end, we tested whether an Emergency Medical Services (EMS) platform could identify patients in the pre-hospital setting who were potential candidates for heart failure (HF) clinical trials. Second, we sought to determine the demographic underpinnings of this population. Methods: The Biospatial platform used EMS electronic patient care reports (ePCR) as the foundational data source. Records of pre-hospital patients with an EMS provider impression of HF were identified through Biospatial’s artificial intelligence algorithm. In a subset of patients, ePCR records in Florida were linked to hospital diagnosis codes utilizing the Florida Health Information Exchange. Results: Between February 1, 2021 and April 30, 2022, we identified 18,198,085 records in the US with a 911 response and patient disposition requiring EMS transport to a local emergency room. There were 63,595 records in which an EMS provider recorded a primary or secondary impression of HF. Of those, 49% were female, 60.3% were White, 22.7% Black, 3.2% Hispanic/Latino, and 13.8% other or unknown. Next, as a test case, the Florida Health Information Exchange was utilized to determine whether an EMS impression of HF was confirmed by a hospital ICD-10 HF code (I50). There were 5363 records in Florida that met the criteria for a 911 call. Of those, 2355 had linked hospital data and 1560 had a populated diagnosis code. Sixty-four percent (64%) of individuals identified by EMS as having HF in the pre-hospital setting received a hospital diagnosis of HF. Conclusion: The utilization of an EMS registry is a novel strategy to identify a diverse population of HF patients for inclusion into clinical trials. Further work is needed to optimize the EMS heart failure algorithm for clinical trial participant identification and to test this strategy for other CV diagnoses such as myocardial infarction and stroke.