ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Accuracy of symptoms and signs for coronary heart disease assessed in primary care.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Trial
- An Integrative Review of the Cardiovascular Disease Spectrum: Integrating Multi-Omics and Artificial Intelligence for Precision Cardiology.Diseases (Basel, Switzerland) · 2026Review
- Profiles of Cough and Associated Risk Factors in Nonhospitalized Individuals With SARS-CoV-2 Omicron Variant Infection: Cross-Sectional Online Survey in China.JMIR public health and surveillance · 2024Article
- Irisin Regulates Cardiac Responses to Exercise in Health and Diseases: a Narrative Review.Journal of cardiovascular translational research · 2023Review
- Sex differences in patterns of referral and resource utilization in the cardiology clinic: an outpatient analysis.Frontiers in cardiovascular medicine · 2023Article
- Article
- Efficacy of ticagrelor in the treatment of stable coronary heart disease: A protocol of systematic review.Medicine · 2020Article
- Observational
- A Nationwide Flash-Mob Study for Suspected Acute Coronary Syndrome.Annals of family medicine · 2019Observational
- Pre-hospital delay in patients with first time myocardial infarction: an observational study in a northern Swedish population.BMC cardiovascular disorders · 2016Observational
- Chest pain out-of-hours - an interview study of primary care physicians' diagnostic approach, tolerance of risk and attitudes to hospital admission.BMC family practice · 2014Article
- Chest pain in primary care: is the localization of pain diagnostically helpful in the critical evaluation of patients?--A cross sectional study.BMC family practice · 2013Article
- Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care.International journal of family medicine · 2013Article
- Coronary heart disease in primary care: accuracy of medical history and physical findings in patients with chest pain--a study protocol for a systematic review with individual patient data.BMC family practice · 2012Article
- Development and validation of a clinical prediction rule for chest wall syndrome in primary care.BMC family practice · 2012Article
- Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule.The British journal of general practice : the journal of the Royal College of General Practitioners · 2012Article
- Multivariate modeling to identify patterns in clinical data: the example of chest pain.BMC medical research methodology · 2011Article
- The diagnosis of coronary heart disease in a low-prevalence setting: follow-up data from patients whose CHD was misdiagnosed by their family doctors.Deutsches Arzteblatt international · 2011Article
- Gender bias revisited: new insights on the differential management of chest pain.BMC family practice · 2011Article
- Accuracy of general practitioners' assessment of chest pain patients for coronary heart disease in primary care: cross-sectional study with follow-up.Croatian medical journal · 2010Article
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10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosing the aetiology of chest pain is challenging. There is still a lack of data on the diagnostic accuracy of signs and symptoms for acute coronary events in low-prevalence settings.
aimTo evaluate the diagnostic accuracy of symptoms and signs in patients presenting to general practice with chest pain. DESIGN OF STUDY: Cross-sectional diagnostic study with delayed-type reference standard.
settingSeventy-four general practices in Germany.
methodThe study included 1249 consecutive patients presenting with chest pain. Data were reviewed by an independent reference panel, with coronary heart disease (CHD) and an indication for urgent hospital admission as reference conditions. Main outcome measures were sensitivity, specificity, likelihood ratio, predictive value, and odds ratio (OR) for non-trauma patients with a reference diagnosis.
resultsSeveral signs and symptoms showed strong associations with CHD, including known vascular disease (OR = 5.13; 95% confidence interval [CI] = 2.83 to 9.30), pain worse on exercise (OR = 4.27; 95% CI = 2.31 to 7.88), patient assumes cardiac origin of pain (OR = 3.20; 95% CI = 1.53 to 6.60), cough present (OR = 0.08; 95% CI = 0.01 to 0.77), and pain reproducible on palpation (OR = 0.27; 95% CI = 0.13 to 0.56). For urgent hospital admission, effective criteria included pain radiating to the left arm (OR = 8.81; 95% CI = 2.58 to 30.05), known clinical vascular disease (OR = 7.50; 95% CI = 2.88 to 19.55), home visit requested (OR = 7.31; 95% CI = 2.27 to 23.57), and known heart failure (OR = 3.53; 95% CI = 1.14 to 10.96).
conclusionAlthough individual criteria were only moderately effective, in combination they can help to decide about further management of patients with chest pain in primary care.
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