SISTER ACT: Safer, Faster Chest Pain Diagnosis in Primary Care

SISTER ACT is a new public-private partnership uniting Maastricht University, Amsterdam UMC, LUMC, UMC Utrecht, iDx, Cordys Analytics, and xConnect to improve the diagnosis of acute chest pain and shortness of breath in primary care. The project aims to develop and validate a practical diagnostic pathway that combines artificial intelligence (AI)-enabled ECG analysis and point-of-care blood tests, supporting general practitioners (GPs) in safely and efficiently assessing patients with thoracic complaints.

Chest pain and dyspnea are common reasons for urgent GP visits, with over 400,000 cases annually in the Netherlands. While most cases are benign, 5–10% may be life-threatening, such as acute coronary syndrome, pulmonary embolism, or aortic dissection. Due to limited diagnostic tools, GPs often refer many patients to emergency departments, resulting in unnecessary hospital visits, high costs, and patient anxiety. There is a clear need for better, faster, and more accessible diagnostic solutions in the GP setting.

The SISTER ACT project will develop an integrated diagnostic platform that includes AI-based ECG interpretation and rapid blood tests (for troponin, D-dimer, NT-proBNP) to support structured clinical decision-making. The pathway will be developed and refined with input from GPs and patients, tested in usability pilots, and evaluated in a large prospective study with 1,000 patients. The approach includes business and climate impact analyses to ensure broad relevance and sustainability.

The main deliverables are a validated diagnostic pathway, an integrated digital platform for AI-ECG and point-of-care tests, and evidence for safe reduction of unnecessary hospital referrals. These results will improve patient experience, reduce healthcare costs and staff burden, and support the implementation of smarter, more sustainable acute care in primary care settings.