The accuracy of general practitioners' clinical assessment of chest pain patients

The European Journal of General Practice
Staffan NilssonSigvard Mölstad

Abstract

To study general practitioners' (GP) assessment of the probability of ischaemic heart disease (IHD) and GP action in daily practice regarding chest pain patients. All chest pain patients aged 20-79 years, attending three primary health-care centres in south-east Sweden and assessed by the GP to have high, low or very low probability of IHD, were included consecutively over a two year period. The "GP action in daily practice" was classed as "active decisions" (investigation or treatment) or "wait and see". "IHD" or "not IHD" was settled according to the results of acute hospital investigation or exercise testing/myocardial perfusion scintigraphy. 516 patients were included, 93 high, 145 low and 278 very low probability cases. The outcome was "IHD" in 47%, 9% and 1% respectively. The sensitivity and specificity of the "GP assessment of the probability of IHD" were 72% and 89%. The sensitivity and specificity of the "GP action in daily practice" were 88% and 72%, respectively. The negative predictive value was 98%. GP assessment, after clinical evaluation, that the probability of IHD was low did not safely rule out IHD. GP action in daily practice however, indicates that general practice is an appropriate level of care for chest p...Continue Reading

Associated Clinical Trials

References

Mar 1, 1997·Journal of the American College of Cardiology·B F StewartC M Otto
Dec 12, 2000·The Western Journal of Medicine·H Patel, M E Herbert
Mar 27, 2001·Family Practice·M EcclesUNKNOWN North of England Stable Angina Guideline Development Group
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Apr 27, 2002·Heart Disease·Wilbert S Aronow
May 15, 2007·Scandinavian Journal of Primary Health Care·Morten ScheikeEva Nylander

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Citations

Feb 1, 2013·International Journal of Family Medicine·Staffan NilssonJan-Erik Karlsson
Aug 18, 2018·Expert Review of Pharmacoeconomics & Outcomes Research·Vladica M VeličkovićUwe Siebert
Jul 9, 2013·The Medical Journal of Australia·William A ParsonageJohn F Younger
Aug 5, 2017·BMC Cardiovascular Disorders·Michelle M A KipRon Kusters
Aug 19, 2014·The Medical Journal of Australia·George A MarshallDevika Thomas

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