Objective: In acute chest pain management, risk stratification tools, including medical history, are recommended. We compared the fraction of patients with sufficient clinical data obtained using computerized history taking software (CHT) versus physician-acquired medical history to calculate established risk scores and assessed the patient-by-patient agreement between these 2 ways of obtaining medical history information.
Materials And Methods: This was a prospective cohort study of clinically stable patients aged ≥ 18 years presenting to the emergency department (ED) at Danderyd University Hospital (Stockholm, Sweden) in 2017-2019 with acute chest pain and non-diagnostic ECG and serum markers. Medical histories were self-reported using CHT on a tablet. Observations on discrete variables in the risk scores were extracted from electronic health records (EHR) and the CHT database. The patient-by-patient agreement was described by Cohen's kappa statistics.
Results: Of the total 1000 patients included (mean age 55.3 ± 17.4 years; 54% women), HEART score, EDACS, and T-MACS could be calculated in 75%, 74%, and 83% by CHT and in 31%, 7%, and 25% by EHR, respectively. The agreement between CHT and EHR was slight to moderate (kappa 0.19-0.70) for chest pain characteristics and moderate to almost perfect (kappa 0.55-0.91) for risk factors.
Conclusions: CHT can acquire and document data for chest pain risk stratification in most ED patients using established risk scores, achieving this goal for a substantially larger number of patients, as compared to EHR data. The agreement between CHT and physician-acquired history taking is high for traditional risk factors and lower for chest pain characteristics.
Clinical Trial Registration: ClinicalTrials.gov NCT03439449.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11187423 | PMC |
| http://dx.doi.org/10.1093/jamia/ocae110 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Treatment of very high risk membranous nephropathy complicated by pulmonary embolism with glucocorticoids and rituximab: Case report.
Medicine (Baltimore)
January 2025
Division of Nephrology, Department of Medicine, National University Hospital, Singapore.
Rationale: We report the efficacy of combination prednisolone and intravenous (IV) rituximab as an immunosuppressive regimen for a young male presenting with extensive venous thromboembolism including a submassive pulmonary embolism secondary to life-threatening nephrotic syndrome from very high risk anti-phospholipase-A2 receptor (PLA2R) positive membranous nephropathy. Initial treatment was with mechanical thrombectomy and anticoagulation. Thereafter, oral prednisolone was initiated to induce remission, during a period of uninterrupted anticoagulation.
View Article and Find Full Text PDFEffect of a Nurse-Led Support Program Using Mobile Application Versus Nurse Phone Advice on Patients at Risk of Coronary Artery Disease: A Randomized Controlled Trial.
Worldviews Evid Based Nurs
February 2025
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Background: Coronary artery disease (CAD) is a major health problem of atherosclerotic cardiovascular (CV) disease and early intervention is regarded important. Given the proven effect of a lifestyle intervention with nursing telephone counselling and mHealth use in health care, yet the comparisons of both support are lacking, this study is proposed.
Objectives: This study aimed to compare the effects of a coronary artery disease (CAD) support program using a mobile application versus nurse phone advice on exercise amount and physical and psychological outcomes for clients at risk of CAD.
A Case of Postherpetic Itch Effectively Treated With Pulsed Radiofrequency Therapy.
Cureus
December 2024
Pain Center, Kouseikai Takai Hospital, Tenri, JPN.
We report a case of a 65-year-old female with postherpetic itch (PHI) over the left chest, who experienced significant relief after pulsed radiofrequency (PRF) therapy. While her initial pain and rash had improved with nerve blocks and medications, she had developed severe itching. PRF therapy significantly reduced the itching, which nearly disappeared.
View Article and Find Full Text PDFCryoglobulinemia Complicated by Pneumonia.
Cureus
December 2024
Pulmonology, Israeli-Georgian Multiprofile Medical Center "Healthycore", Tbilisi, GEO.
This study describes a 64-year-old female with a history of hepatitis C and cryoglobulinemia, who presented with respiratory symptoms, including dry cough, shortness of breath, and fever, alongside joint pain and fatigue. Initial workup revealed interstitial pneumonia, supported by chest imaging, and the patient was treated for pneumonia with standard antibiotic therapy. Despite no renal involvement, a hallmark of cryoglobulinemia, further testing confirmed elevated serum cryoglobulin levels.
View Article and Find Full Text PDFAtypical Presentation of Andersen-Tawil Syndrome: Heart Failure with Reduced Ejection without Periodic Paralysis or Dysmorphic Features.
Eur J Case Rep Intern Med
December 2024
Internal Medicine, Holy Family Hospital, Rawalpindi, Pakistan.
Background: Andersen-Tawil syndrome (ATS) is a rare autosomal dominant disorder caused by variants in the gene. It is associated with periodic paralysis, dysmorphic features and cardiac arrhythmias. The syndrome exhibits incomplete penetrance, leading to a broad spectrum of clinical manifestations, making diagnosis challenging.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!