Lidkoping

Researchers are working to develop a decision support system that helps emergency medical service (EMS) personnel assess patients who have chest pain before they reach the hospital. The study focuses on evaluating a machine learning model that aims to improve decision making for these patients by identifying time-sensitive conditions like heart attacks and strokes. Prehospital care is evolving to ensure patients receive the right level of care quickly, balancing the need for urgent hospital treatment against safe alternatives like primary care or self-care advice. Participants will be monitored using routine data collected at the scene, including responses to questions about medical history and pain characteristics. In addition, one blood sample will be taken to measure troponin and glucose levels, either from a capillary sample or a venous sample if a catheter is already in place. The blood tests are analyzed immediately, and results are recorded in the clinical report form. The study does not change the standard care patients receive, which typically involves transport to the emergency department for further evaluation. During the study, participants will respond to questions asked by ambulance nurses and consent to data collection from medical records and blood testing. Researchers will monitor patient outcomes, including serious events and death, from the time EMS is contacted through follow-up periods ranging from one day up to 100 days. The study aims to validate and improve the decision support model to enhance patient safety and optimize care pathways for people experiencing chest pain.

Researchers are examining the effect of physical exercise during neoadjuvant chemotherapy (NACT) on breast cancer outcomes, focusing on pathological complete response (pCR), which means no invasive tumor remains after treatment. The Neo-ACT trial is designed to evaluate if supervised high-intensity interval and resistance training can increase pCR rates in patients with primary invasive breast cancer. Secondary goals include assessing residual cancer burden, tumor response via imaging, quality of life, physical activity, muscle strength, fitness, treatment-related toxicities, cognitive function, chemotherapy completion, and long-term sick leave. Participants are randomly assigned to either an exercise group or usual care. Those in the exercise group complete 120 minutes of supervised exercise weekly during NACT until surgery, about five months, supported by a personalized mobile app and local physiotherapists. Exercise sessions include warm-ups and are tailored based on individual fitness and perceived exertion. Physical activity is carefully monitored throughout the trial. During the study, participants undergo various assessments including tumor response scans, questionnaires about quality of life and physical activity, muscle strength and fitness tests, and cognitive evaluations. Physical activity levels are tracked using a Fitbit device, and safety is monitored through hospital admission records and toxicity assessments. Patients will be followed for up to two years to evaluate long-term outcomes and treatment effects.

Heart failure with preserved ejection fraction (HFPEF) is a common and serious condition without effective treatment options. Researchers are evaluating whether adding spironolactone, a medication, to standard care can reduce the combined risk of cardiovascular death and hospitalizations for heart failure in patients with HFPEF. This study is a Phase 3 trial including patients from the Swedish Heart Failure Registry and the US, all having symptoms of heart failure, elevated heart-related blood markers, and an ejection fraction of 40% or higher. Participants are randomly assigned to one of two groups: one receiving spironolactone along with usual care, and the other receiving usual care alone without spironolactone. The study is designed as a registry-randomized clinical trial and will continue until 721 cardiovascular death or heart failure hospitalization events occur, with an enrollment period of 7 years and a total study duration of 9 years. Data collection in Sweden uses registry linkages, while data in the US comes from site reports and supplemented call center follow-up. During the study, researchers will monitor participants for hospitalizations due to heart failure or cardiovascular death as the primary outcome. Secondary outcomes include other hospitalizations, side effects, and how well patients follow their treatment plans. Outcomes are tracked through national registries and direct reporting, with the main data locked and analyzed five years after the study begins. Approximately 2000 patients aged 50 to 99 years will be included to achieve the event target needed for study conclusions.