Talk:Door-to-balloon

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Do we need this page?[edit]

Door to balloon time is important, but I'm not convinced that wikipedia is best served by having a seperate article on it. Wouldn't the information be better in an article on myocardial infarction or coronary angioplasty? --John24601 17:45, 2 July 2007 (UTC)

Have you seen how large the myocardial infarction article is already? Door-to-balloon is a complex multidisciplinary process that transcends coronary angioplasty. It's also an important performance matrix for hospitals. It has stand-alone value to anyone interested in improving door-to-balloon times or cultivating a regional PCI program. MoodyGroove 20:38, 2 July 2007 (UTC)MoodyGroove
Perhaps, but it seems to me that door-to-balloon time is merely an index for likely successful treatment with angioplasty following myocardial infarction. It has no meaning outside of these two articles. If the MI article is getting too long, then I'd prefer to split it along more user-friendly lines (e.g. have an article on emergency treatment, and have this in it). The stuff in the articles does deserve inclusion somewhere, I'm just not sure that it should be in its own article. Almost no articles link to this one, even though it's been around a good 6 months, and I can't imagine anybody searching for it. Anybody who knows anything about the topic knows what D2B time is all about, anybody who doesn't (and hence is going to be reading about MI on here) is going to be looking to the MI page for their information --John24601 07:19, 3 July 2007 (UTC)
It is an index for quality, and does relate to successful treatment with angioplasty, but the subject does not belong to angioplasty. D2B overlaps with, but is a separate topic from "emergency treatment of STEMI" which I agree should probably have its own article. I can definitely see someone searching for how to improve door-to-balloon times. There are thousands of people, both clinical and non-clinical, who work in health care risk management, quality improvement, patient safety, regulatory affairs, and government compliance. MoodyGroove 14:00, 3 July 2007 (UTC)MoodyGroove
I should also mention that I respectfully disagree with your comment that "anybody who knows anything about the topic knows what D2B time is all about." Having worked extensively in my own community to help reduce D2B/E2B times, I can tell you first hand there is a huge education gap. Several of the stakeholders, including most of the ER nurses and paramedics, were hearing the term "STEMI" for the first time. Cardiologists giving up control to emergency physicians, and emergency physicians giving up control to EMS is a step-wise process that involves a lot of growing pains. "One expert, Dr. Steve Nissen, president of the American College of Cardiology, puts it bluntly: 'Many hospitals in America don't know what they are doing.'"[1] MoodyGroove 16:45, 3 July 2007 (UTC)MoodyGroove
This article is fairly extensive and well-referenced. I think that is better to keep this article separate, with a link from myocardial infarction. Axl 08:41, 3 July 2007 (UTC)
I concur. Myocardial infarction is too big an article as is and needs more "break out" articles such as this. Ksheka 01:05, 4 July 2007 (UTC)

There are old references that thought door to balloon time would improve patient oriented outcomes. Now that the rule has been implemented the best medical evidence shows no benefit.

"Despite improvements in door-to-balloon times, there was no significant overall change in unadjusted in-hospital mortality (4.8% in 2005–2006 and 4.7% in 2008–2009, P=0.43 for trend) or in risk-adjusted in-hospital mortality (5.0% in 2005–2006 and 4.7% in 2008–2009, P=0.34), nor was a significant difference observed in unadjusted 30-day mortality (P=0.64)."

Door-to-Balloon Time and Mortality among Patients Undergoing Primary PCI Daniel S. Menees, M.D., Eric D. Peterson, M.D., Yongfei Wang, M.S., Jeptha P. Curtis, M.D., John C. Messenger, M.D., John S. Rumsfeld, M.D., Ph.D., and Hitinder S. Gurm, M.B., B.S. N Engl J Med 2013 — Preceding unsigned comment added by 66.74.182.150 (talk) 23:20, 18 January 2014 (UTC)

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