title: Transitions, Risks, and Actions in Coronary Events--Center for Outcomes Research and Education (TRACE-CORE): design and rationale.
abstract: BACKGROUND
  Cardiovascular disease continues to cause significant morbidity, mortality, and impaired quality of life, with unrealized health gains from the underuse of available evidence. The Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE) aims to advance the science of acute coronary syndromes by examining the determinants and outcomes of the quality of transition from hospital to community and by quantifying the impact of potentially modifiable characteristics associated with decreased quality of life, rehospitalization, and mortality.
  
  
  RESULTS
  TRACE-CORE comprises a longitudinal multiracial cohort of patients hospitalized with acute coronary syndromes, 2 research projects, and development of a nucleus of early stage investigators. We are currently enrolling 2500 adults hospitalized for acute coronary syndromes at 6 hospitals in the northeastern and southeastern United States. We will follow these patients for 24 months after hospitalization through medical record abstraction and 5 patient interviews focusing on quality of life, cardiac events, rehospitalizations, mortality, and medical, behavioral, and psychosocial characteristics. The Transitions Project studies determinants of and disparities in outcomes of the quality of patients' transition from hospital to community. Focusing on potentially modifiable factors, the Action Scores Project will develop and validate action scores to predict recurrent cardiac events, death, and quality of life, describe longitudinal variation in these scores, and develop a dashboard for patient and provider action on the basis of these scores.
  
  
  CONCLUSIONS
  In TRACE-CORE, sound methodologic principles of observational studies converge with outcomes and effectiveness research approaches. We expect that our data, research infrastructure, and research projects will inform the development of novel secondary prevention approaches and underpin the careers of cardiovascular outcomes researchers.
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01655, USA. molly.waring@umassmed.edu
authors.forename: Molly E
authors.initials: ME
authors.lastname: Waring
authors.forename: Richard H
authors.initials: RH
authors.lastname: McManus
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.forename: Milena D
authors.initials: MD
authors.lastname: Anatchkova
authors.forename: David D
authors.initials: DD
authors.lastname: McManus
authors.forename: Randolph S
authors.initials: RS
authors.lastname: Devereaux
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
authors.forename: Jeroan J
authors.initials: JJ
authors.lastname: Allison
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D003153:Community Health Services / Q000592:standards*; D003266:Continuity of Patient Care / Q000592:standards*; D005500:Follow-Up Studies; D006302:Health Services Research; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D010359:Patient Readmission / Q000592:standards; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000592:standards*; D011788:Quality of Life; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States