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European Heart Journal 1993 14(4):441-446;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Prospective evaluation of an EDB-based diagnostic program to be used in patients admitted to hospital with acute chest pain

J. JONSBU, O. AASE, A. ROLLAG, K. LIESTØL* and J. ERIKSSEN

Medical Department, Central Hospital of Akershus 1474 Nordbyhagen
*Department of Informatics, University of Oslo 0316 Oslo, Norway

Received 18 May 1992; revised 21 September 1992; .

Correspondence: Jørgen Jonsbu, MD, Medical Department, Central Hospital of Akershus, N-Nordbyhagen, Norway

Abstract

A recently designed computer based decision support system (DSP), almost exclusively based on case history data, was developed to facilitate immediate differentiation between patients with and without urgent need for coronary care unit (CCU) transferral from the emergency room, and additionally to distinguish between patients with and without acute myocardial infarction (MI).

One-year's prospective testing in a consecutive series of 1252 patients with acute chest pain revealed that the DSP, used in addition to ECG and clinical examination, demonstrated a sensitivity of 96% in the detection of patients in need of CCU observation (MI-sensitivity of 98%), and a specificity of 56% in excluding patients who were not in need of CCU observation. The proportion of referrals to the CCU judged to be unnecessary was only 17% of the total number of patients seen in the emergency room.

Key Words: Acute chest pain • acute coronary disease • case history • decision support system • coronary care units


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