Evidence map›Paper›PMID 25622029›Full record

ArticlePloS one2015

Clinical outcomes and cost effectiveness of accelerated diagnostic protocol in a chest pain center compared with routine care of patients with chest pain.

Elad Asher, Haim Reuveni, Nir Shlomo, Yariv Gerber, Roy Beigel, Michael Narodetski, Michael Eldar, Jacob Or, Hanoch Hod, Arie Shamiss and 1 more

Open access · goldAbstract readComparative Study
In one paragraph

Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Elad AsherLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Haim ReuveniBen Gurion University of the Negev, Soroka Medical Center, Beer Sheva, Israel.
Nir ShlomoLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Yariv GerberThe School of Public Health, the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Roy BeigelLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Michael NarodetskiLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Michael EldarLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Jacob OrEmergency Medicine Department, Sheba Medical Center, Tel Hashomer, Israel.
Hanoch HodLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Arie ShamissSheba Medical Center, Tel Hashomer, Israel.
Shlomi MatetzkyLeviev Heart Center, Sheba Medical Center, Tel Hashomer, Israel.
Sheba Medical Center · ILBen-Gurion University of the Negev · ILTel Aviv University · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe aim of this study was to compare in patients presenting with acute chest pain the clinical outcomes and cost-effectiveness of an accelerated diagnostic protocol utilizing contemporary technology in a chest pain unit versus routine care in an internal medicine department. METHODS AND

resultsHospital and 90-day course were prospectively studied in 585 consecutive low-moderate risk acute chest pain patients, of whom 304 were investigated in a designated chest pain center using a pre-specified accelerated diagnostic protocol, while 281 underwent routine care in an internal medicine ward. Hospitalization was longer in the routine care compared with the accelerated diagnostic protocol group (p<0.001). During hospitalization, 298 accelerated diagnostic protocol patients (98%) vs. 57 (20%) routine care patients underwent non-invasive testing, (p<0.001). Throughout the 90-day follow-up, diagnostic imaging testing was performed in 125 (44%) and 26 (9%) patients in the routine care and accelerated diagnostic protocol patients, respectively (p<0.001). Ultimately, most patients in both groups had non-invasive imaging testing. Accelerated diagnostic protocol patients compared with those receiving routine care was associated with a lower incidence of readmissions for chest pain [8 (3%) vs. 24 (9%), p<0.01], and acute coronary syndromes [1 (0.3%) vs. 9 (3.2%), p<0.01], during the follow-up period. The accelerated diagnostic protocol remained a predictor of lower acute coronary syndromes and readmissions after propensity score analysis [OR = 0.28 (CI 95% 0.14-0.59)]. Cost per patient was similar in both groups [($2510 vs. $2703 for the accelerated diagnostic protocol and routine care group, respectively, (p = 0.9)].

conclusionAn accelerated diagnostic protocol is clinically superior and as cost effective as routine in acute chest pain patients, and may save time and resources.

Indexed as

AgedChest PainCost-Benefit AnalysisFemaleHealth Care CostsHumansMaleMiddle AgedPain ClinicsProspective StudiesTreatment Outcome

Identifiers

PMID25622029
PMCPMC4306554
OpenAlexW1971641495

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.