Missing acute cardiovascular diseases is one of the most common emergencies in general practice centers in the Netherlands. Early identification followed by correct assessment of urgency are of vital importance. Safety First focuses on optimization of telephone triage for acute cardiovascular diseases.

Initial contact with patients at the general practice center takes place by means of telephone triage. Since 2011, most general practice centers use the Netherlands Triage Standard (NTS) as an aid to decide the level of urgency. This decision aid has been developed to improve the decision-making process and patient safety by means of a structured urgency assessment. It is not clear yet whether this improvement has been realized. Despite the existence of diagnostic decision aids, telephone triage is considered a complex and challenging task, particularly in case of suspected acute cardiovascular diseases, where getting the right patient care quickly is of vital importance.

The Safety First study is a cross-sectional study including a total of 4,000 telephone triage interviews. The objective of the study is to develop clinical prediction rules for TIA/CVA and ACS with determinants that best predict the absence or presence of disease/urgency based on the initial anamnesis and patient characteristics. We validate the telephone interviews with the ultimate diagnosis in follow-ups as included in the general practitioners' medical records. We use logistic regression analysis for diagnostic modeling.

As a scientific internship student you can actively participate in the Safety First study in both the collection and analysis of data. Data collection is done by the staff office of Primair Huisartsenposten (Lunetten, Utrecht), where you will be working for most of your internship. You can use these data to write a final report. This will give you a better understanding of cardiovascular epidemiology and safety in primary care. You will also learn scientific reasoning and writing. Are you interested in acute cardiovascular diseases and general medicine? Then contact us!