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A Nationwide Flash-Mob Study for Suspected Acute Coronary Syndrome
- Source :
- Annals of Family Medicine, 17(4), 296-303, Annals of Family Medicine, 17, 296-303, Annals of Family Medicine, 17, 4, pp. 296-303, Annals of Family Medicine, 17(4), 296-303. Annals of Family Medicine, Inc
- Publication Year :
- 2019
-
Abstract
- PURPOSE Our primary objective was to evaluate the Marburg Heart Score (MHS), a clinical decision rule, or to develop an adapted clinical decision rule for family physicians (FPs) to safely rule out acute coronary syndrome (ACS) in patients referred to secondary care for suspected ACS. The secondary objective was to evaluate the feasibility of using the flash-mob method, an innovative study design, for large-scale research in family medicine. METHODS In this 2-week, nationwide, prospective, observational, flash-mob study, FPs collected data on possible ACS predictors and assessed ACS probability (on a scale of 1-10) in patients referred to secondary care for suspected ACS. RESULTS We collected data for 258 patients in 2 weeks by mobilizing approximately 1 in 5 FPs throughout the country via ambassadors. A final diagnosis was obtained for 243 patients (94.2%), of whom 45 (18.5%) received a diagnosis of ACS. Sex, sex-adjusted age, and ischemic changes on electrocardiography were significantly associated with ACS. The sensitivity of the MHS (cut-off ≤2) was 75.0%, specificity was 44.0%, positive predictive value was 24.3%, and negative predictive value was 88.0%. For the FP assessment (cut-off ≤5), these test characteristics were 86.7%, 41.4%, 25.2%, and 93.2%, respectively. CONCLUSIONS For patients referred to emergency care, ACS could not be safely ruled out using the MHS or FP clinical assessment. The flash-mob study design may be a feasible alternative research method to investigate relatively simple, clinically relevant research questions in family medicine on a large scale and over a relatively short time frame.
- Subjects :
- Male
Acute coronary syndrome
medicine.medical_specialty
Heart disease
HEART-DISEASE
CHEST-PAIN
Chest pain
clinical decision rule
VALIDATION
Decision Support Techniques
Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18]
acute coronary syndrome
Secondary care
03 medical and health sciences
family medicine
0302 clinical medicine
All institutes and research themes of the Radboud University Medical Center
flash mob research
medicine
Humans
Family
In patient
030212 general & internal medicine
Prospective Studies
Original Research
Research method
Aged
medicine.diagnostic_test
business.industry
Data Collection
Social Support
Middle Aged
CARE
medicine.disease
TIME
Editorial
ROC Curve
Case-Control Studies
Emergency medicine
Feasibility Studies
Observational study
Female
JUDGMENT
medicine.symptom
business
Family Practice
Electrocardiography
Social Media
Subjects
Details
- Language :
- English
- ISSN :
- 15441709
- Database :
- OpenAIRE
- Journal :
- Annals of Family Medicine, 17(4), 296-303, Annals of Family Medicine, 17, 296-303, Annals of Family Medicine, 17, 4, pp. 296-303, Annals of Family Medicine, 17(4), 296-303. Annals of Family Medicine, Inc
- Accession number :
- edsair.doi.dedup.....6b34ec09f224c39ec1cc28052ba2dbf3