Key result
Low pretest probability of CAD by Diamond and Forrester score was associated with a 0% rate of ACS (95% CI 0-0.66%), suggesting stress testing may be safely avoided in this group.
Why the study?
Does the Diamond and Forrester pretest probability score predict stress test utilization and acute coronary syndrome in patients admitted to a chest pain observation unit?
Population
3,552 consecutively admitted chest pain observation unit patients in a large-volume academic urban emergency…
Design
Cohort
Authors
Loading...
May support omitting stress testing in low-probability observation patients; hypothesis-generating and requires prospective validation before practice change.
Cohort (n=3,552)
No
Does the Diamond and Forrester pretest probability score predict stress test utilization and acute coronary syndrome in patients admitted to a chest pain observation unit?
p-value: p=<0.01
In patients admitted to a chest pain observation unit, a low Diamond and Forrester pretest probability score identifies a cohort with near-zero risk of ACS, suggesting stress testing may be safely avoided in this group.
Anthony M. Napoli (2014) conducted a cohort in Chest pain (n=3,552). Pretest probability of CAD (Diamond and Forrester score) vs. Low vs intermediate vs high risk groups was evaluated on Risk of acute coronary syndrome (ACS) (95% CI 0-0.66, p=<0.01). Low pretest probability of CAD by Diamond and Forrester score was associated with a 0% rate of ACS (95% CI 0-0.66%), suggesting stress testing may be safely avoided in this group.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: