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TRIGGER

Start date:
Historic
End date:
March 2014
Co-ordinated by:
National Health Services Blood and Transplant Services

Transfusion in Gastrointestinal Bleeding

Aim

To evaluate the feasibility and safety of implementing a restrictive versus liberal red blood cell (RBC) transfusion policy in adult patients admitted with Acute Upper Gastrointestinal Bleeding (AUGIB) in order to inform the design of a definitive phase III randomised controlled trial.

Trial Design

A multi-centre, feasibility, cluster randomised controlled trial comparing restrictive versus liberal blood transfusion strategies in adult patients admitted with acute upper gastrointestinal bleeding

Chief Investigator

Professor Mike Murphy & Dr, Vipul Jairath 

Local PI

Professor Alasdair Gray

List of Publications – References

Vipul Jairath, Brennan C Kahan, Alasdair Gray, Caroline J Doré, Ana Mora, Martin W James, Adrian J Stanley, Simon M Everett, Adam A Bailey, Helen Dallal, John Greenaway, Ivan Le Jeune, Melanie Darwent, Nicholas Church, Ian Reckless, Renate Hodge, Claire Dyer, Sarah Meredith, Charlotte Llewelyn, Kelvin R Palmer, Richard F Logan, Simon P Travis, Timothy S Walsh, Michael F Murphy: Restrictive versus liberal blood transfusion for acute uppergastrointestinal bleeding (TRIGGER): a pragmatic, open-label,cluster randomised feasibility trial. The Lancet Published online May 6, 2015

Local PI

Professor Alasdair Gray

Honorary Professor of Emergency Medicine & Clinical Director of the Emergency Department

Research Team

Judy Coyle

Scottish Research Nurse of the Year 2015 (SRNCN)

More EMERGE Trials

Trauma remains a major cause of mortality and morbidity. 10% of blunt force trauma patients admitted to a major trauma centre will have sustained one or more fractured ribs, which may cause significant pain and problems with breathing.

To establish the outcome of rib fractures and their treatments it is important to know what to measure, and how to measure this accurately. A patient reported outcome measure (PROM) is a questionnaire used to measure patient reported outcomes, to show how the patient is doing from their perspective.

Whilst there is ongoing interest in surgery to fix broken ribs, there is no PROM specifically designed for patients with broken ribs following chest trauma. Therefore, it is not clear whether the symptoms that are most important to these patients are being represented by the current outcome measures. This study aims to create a PROM specific to rib fracture patients to give us a better understanding of whether a new treatment actually makes a difference to the patient’s recovery.

The 1st part of the study involves asking patients with rib fractures to help design a new PROM. This will be conducted through focus groups at a site in Nottingham. The 2nd part of the study entails field testing, whereby patients with rib fractures will be asked to test this new PROM. This will be conducted across multiple secondary care settings in the UK, including the Royal Infirmary of Edinburgh. The study is expected to run for approximately 2 years, with recruitment targets of 50 patients for the PROM Creation phase and 250 for the Field Testing phase.

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PROM OCTS

The RECOVERY Trial

Randomised Evaluation of COVID-19 Therapy

To determine the association between high-sensitivity cardiac troponin concentration and obstructive coronary artery disease in patients presenting to the Emergency Department with suspected acute coronary syndrome and cardiac troponin concentration within the normal reference range using CTCA.

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PRECISE-CTCA Trial

To determine the association between high-sensitivity cardiac troponin concentration and obstructive coronary artery disease in patients presenting to the Emergency Department with suspected acute coronary syndrome and cardiac troponin concentration within the normal reference range using CTCA.