Quantifying Patient-Physician Communication and Perceptions of Risk During Admissions for Possible Acute Coronary Syndromes

Annals of Emergency Medicine
David H NewmanKaushal H Shah

Abstract

Disposition decision for patients with possible acute coronary syndrome in the emergency department (ED) is driven primarily by perception of short-term risks. We sought to evaluate communication between patient and physician about these risks by ascertaining the content of discussions surrounding disposition decision. We conducted matched-pair surveys of patients admitted for possible acute coronary syndrome and their physicians in 2 academic, inner-city EDs. After disposition conversation, trained research assistants administered surveys querying perceived and communicated risk estimates and purpose of admission. Primary exclusion criteria were ECG or troponin value diagnostic of acute coronary syndrome. The primary outcome measure was agreement in assessment of the risk of myocardial infarction, defined as the proportion of patient-physician pairs whose risk estimates were within 10% of each other. A total of 425 patient-physician survey pairs were collected. Fifty-three percent of patients were men. Patients reported discussing the likelihood of their symptoms' being due to myocardial infarction in 65% of cases, whereas physicians reported this in 46%. After their discussion, physicians' (n=415) median estimate of short-ter...Continue Reading

Associated Clinical Trials

References

Apr 20, 2000·The New England Journal of Medicine·J H PopeH P Selker
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Citations

May 14, 2017·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Arash MokhtariUlf Ekelund
Oct 27, 2018·Open Heart·Alexander T LimkakengL Kristin Newby
Jan 27, 2019·Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews·Fabio J R PencleKingsley R Chin
Nov 13, 2018·Critical Pathways in Cardiology·Sabina B GesellSimon A Mahler

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