ArticleCroatian medical journal2010
Accuracy of general practitioners' assessment of chest pain patients for coronary heart disease in primary care: cross-sectional study with follow-up.
Article in Croatian medical journal, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- The HEART-GP strategy for ruling out acute coronary syndrome in out-of-hours primary care: a diagnostic accuracy trial protocol.Contemporary clinical trials communications · 2026Article
- Mechanisms of decision-making in preoperative assessment for older adult prostate cancer patients-A qualitative study.Journal of surgical oncology · 2020Article
- Observational
- Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome.Open access Macedonian journal of medical sciences · 2019Article
- The conundrum of acute chest pain in general practice: a nationwide survey in The Netherlands.BJGP open · 2018Article
- Managing chest pain patients in general practice: an interview-based study.BMC family practice · 2018Article
- Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study.BMC family practice · 2014Observational
- How accurate is diagnosis of congenital anomalies made by family physicians?Health promotion perspectives · 2014Article
- May chest pain describe coronary heart disease?Croatian medical journal · 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
- Development and validation of a clinical prediction rule for chest wall syndrome in primary care.BMC family practice · 2012Article
- 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
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9 authors.
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Abstract
aimTo estimate how accurately general practitioners' (GP) assessed the probability of coronary heart disease in patients presenting with chest pain and analyze the patient management decisions taken as a result.
methodsDuring 2005 and 2006, the cross-sectional diagnostic study with a delayed-type reference standard included 74 GPs in the German state of Hesse, who enrolled 1249 consecutive patients presenting with chest pain. GPs recorded symptoms and findings for each patient on a report form. Patients and GPs were contacted 6 weeks and 6 months after the patients' visit to the GP. Data on chest complaints, investigations, hospitalization, and medication were reviewed by an independent panel, with coronary heart disease being the reference condition. Diagnostic properties (sensitivity, specificity, and predictive values) of the GPs' diagnoses were calculated.
resultsGPs diagnosed coronary heart disease with the sensitivity of 69% (95% confidence interval [CI], 62-75) and specificity of 89% (95% CI, 87-91), and acute coronary syndrome with the sensitivity of 50% (95% CI, 36-64) and specificity of 98% (95% CI, 97-99). They assumed coronary heart disease in 245 patients, 41 (17%) of whom were referred to the hospital, 77 (31%) to a cardiologist, and 162 (66%) to electrocardiogram testing.
conclusionsGPs' evaluation of chest pain patients, based on symptoms and signs alone, was not sufficiently accurate for diagnosing or excluding coronary heart disease or acute coronary syndrome.
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