Preamble

Dear Colleague,

Evidence from prospective randomised trials forms the basis for our therapeutic decisions in individual patients.
Over the past 20 years a great number of important prospective randomised trials have been performed in the field of cardiology.

In guidelines resulting from these trials, experts rate the available evidence and give recommendations regarding the choice of diagnostic and therapeutic options.
In order to access this wealth of evidence, it is critical to expand the methods for sharing information, especially when the time window for decision-making is narrow. Furthermore, quickly accessible and specific data are needed to ensure that a given patient’s characteristics conform to those of the patients treated in a given clinical trial, and therefore that similar treatment effects can be expected.

The pilot project presented here offers quick and structured access to the ESC-guideline on acute coronary syndromes without ST-elevation. There is also a database containing the prospective randomised studies on use of GP IIb/IIIa antagonists in acute coronary syndromes.
This is not an “expert system” but aims to support the expert in getting the specific information needed to treat individual patients.

The principal rules for construction of the database (Systematic Trial Analysis and Review, STAR^®) were:

• Inclusion of studies according to the grade of evidence. This database includes only studies of grade 1 evidence (according to Sackett, prospective randomised trials, metaanalysis).
• Only data from original full paper publications are presented (no data on file, personal communications, etc.).
• Study presentations always follow the same sequence (see menu on the left side of the screen), facilitating access to specific data and their comparison to other studies.
• All numbers, figures and tables mentioned in a study are shown in full. From the “Patients and Methods” section, the relevant original wording is selected. This process of selection is currently under evaluation by the Institute for Language Processing of the University of Cologne, using methods of context sensitive language analysis.
• Studies have been included that contain at least a subgroup with an acute coronary syndrome.
• All studies can be compared with one another at the same level (e.g. inclusion criteria, baseline characteristics, etc.).
• Studies dealing with the same clinical scenario (e.g. early intervention) can be compared to one another in a split screen version.
  

Last but not least, we kindly ask you to answer the survey, which will help the ESC and the authors of this project to further develop this tool according to your needs. As a next step in this process it is intended to program a search facility in order to find the specific information wanted even more quickly.