In this single institutional study of low risk chest pain patients (symptoms but no ischemia on EKG), ED physicians were randomly assigned to receive a quantitative pre-test probability of ACS, based on patient factors. Of those patients who ended up not having any CV diagnosis, those in the intervention group were less likely to get admitted (5% versus 11% of controls), less likely to recieve an imaging test (9% versus 19%) and were more likely to be satisfied with the explanation of their condition from the physician (49% versus 38%) (abstract). This adds to the literature that decision support, with quantitative pre-test probabilities, can improve physician decision making, resulting in less resource utilization and higher patient satisfaction. For a copy of the decision support used in this study, see appendix E1 on-line (decision support).
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]