Key result
In primary care patients presenting with chest pain, known clinical vascular disease was the strongest predictor of coronary heart disease (OR 5.13), while pain reproducible on palpation reduced its likelihood.
Why the study?
Does clinical assessment of symptoms and signs accurately diagnose coronary heart disease and the need for urgent hospital admission in primary care patients with chest pain?
Cross-Sectional (n=1,249)
Yes
Does clinical assessment of symptoms and signs accurately diagnose coronary heart disease and the need for urgent hospital admission in primary care patients with chest pain?
Effect estimate: OR 5.13 (95% CI 2.83-9.30)
p-value: p=<0.001
While individual symptoms and signs have limited diagnostic accuracy for CHD in primary care, specific combinations can effectively guide decisions regarding urgent hospital admission.
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Vascular disease history aids CHD risk assessment in primary care chest pain; extends diagnostic models but requires prospective validation.
Bösner et al. (2010) conducted a cross-sectional in Chest pain (n=1,249). Clinical symptoms and signs assessment vs. Reference panel diagnosis was evaluated on Diagnostic accuracy of known clinical vascular disease for coronary heart disease (OR 5.13, 95% CI 2.83-9.30, p=<0.001). In primary care patients presenting with chest pain, known clinical vascular disease was the strongest predictor of coronary heart disease (OR 5.13), while pain reproducible on palpation reduced its likelihood.
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