Reviews the evolution of medical decision making, predictive instruments, and consensus guidelines for patients presenting with chest pain.
Provides historical context for chest pain risk tools; leaves open how best to incorporate novel predictors into updated guidelines.
Medical decision making in patients who present with chest pain or other symptoms suggestive of acute coronary disease continues to evolve amid new forms of technology and treatment, limitations on resources, and substantial local variation in the number and types of intensive care unit beds. Recent work has ranged from the development of predictive instruments to assist in decisions about hospital admission to the development and testing of consensus guidelines for use in decisions about admission and transfer for patients in advanced care units.The principles underlying these instruments and guidelines are based on information traditionally used by doctors in . . .
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Kim A. Eagle (1991) studied this question.