Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study.

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State: Public
Version: Final published version
Serval ID
serval:BIB_41938A2D4157
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Predictive ability of an early diagnostic guess in patients presenting with chest pain; a longitudinal descriptive study.
Journal
BMC family practice
Author(s)
Verdon F., Junod M., Herzig L., Vaucher P., Burnand B., Bischoff T., Pécoud A., Favrat B.
ISSN
1471-2296 (Electronic)
ISSN-L
1471-2296
Publication state
Published
Issued date
21/02/2010
Peer-reviewed
Oui
Volume
11
Pages
14
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't ; Validation Studies
Publication Status: epublish
Abstract
The intuitive early diagnostic guess could play an important role in reaching a final diagnosis. However, no study to date has attempted to quantify the importance of general practitioners' (GPs) ability to correctly appraise the origin of chest pain within the first minutes of an encounter.
The validation study was nested in a multicentre cohort study with a one year follow-up and included 626 successive patients who presented with chest pain and were attended by 58 GPs in Western Switzerland. The early diagnostic guess was assessed prior to a patient's history being taken by a GP and was then compared to a diagnosis of chest pain observed over the next year.
Using summary measures clustered at the GP's level, the early diagnostic guess was confirmed by further investigation in 51.0% (CI 95%; 49.4% to 52.5%) of patients presenting with chest pain. The early diagnostic guess was more accurate in patients with a life threatening illness (65.4%; CI 95% 64.5% to 66.3%) and in patients who did not feel anxious (62.9%; CI 95% 62.5% to 63.3%). The predictive abilities of an early diagnostic guess were consistent among GPs.
The GPs early diagnostic guess was correct in one out of two patients presenting with chest pain. The probability of a correct guess was higher in patients with a life-threatening illness and in patients not feeling anxious about their pain.

Keywords
Chest Pain/etiology, Cohort Studies, Early Diagnosis, Gastrointestinal Diseases/complications, Gastrointestinal Diseases/diagnosis, Heart Diseases/complications, Heart Diseases/diagnosis, Humans, Lung Diseases/complications, Lung Diseases/diagnosis, Multicenter Studies as Topic, Physicians, Family, Predictive Value of Tests, Switzerland
Pubmed
Web of science
Open Access
Yes
Create date
23/02/2010 14:41
Last modification date
20/08/2019 13:42
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