Key result
Predictive instrument reduces inappropriate CCU admissions by ~25% for emergency room patients without acute ischemia.
Why the study?
Half of patients admitted to coronary care units for suspected acute ischemic heart disease are ultimately found not to have the diagnosis, motivating development of a diagnostic aid to reduce unnecessary CCU admissions.
Absolute Event Rate: 33% vs 44%
p-value: p=0.003
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May aid ER triage to reduce unnecessary CCU admissions; leaves open prospective validation of real-world impact.
Selker et al. (1988) studied Suspected acute ischemic heart disease (n=2,320). Predictive instrument for acute cardiac ischemia vs. Standard diagnostic practice was evaluated on Proportion of patients admitted to the coronary care unit without acute ischemia (p=0.003). Making a predictive instrument's probability value available to ER physicians reduced the proportion of CCU admissions for patients without true acute ischemia from 44% to 33% (p=0.003).
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