© 2002 by Heart
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Ischaemic heart disease
Improving triage of chest pain: man and computer combined? 
In US studies, 2% of acute myocardial infarction (MI) and 2% of unstable angina patients are wrongly triaged as low risk and sent home. These patients suffer a 1.9x higher mortality than those treated appropriately. This study compared physicians to a computer model for 20 simulated scenarios. The experience level of physicians did not affect performance, and all were more cautious than the model, leading to lower sensitivity (85% v 96%, p = 0.02). However, physicians sent home 2.4% of patients when complications would have occurred versus 0.6% for the model. Physicians may be able to use the model, combined with biochemical markers, to improve their performance. Since the model requires a history to be properly taken, the physician has not (yet) become redundant.
Reilly BM, Evans AT, Schaider JJ, Wang Y. Triage of patients with chest pain in
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