Title |
External validation of the emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP)
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Published in |
Emergency Medicine Journal, July 2016
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DOI | 10.1136/emermed-2015-205028 |
Pubmed ID | |
Authors |
Dylan Flaws, Martin Than, Frank Xavier Scheuermeyer, James Christenson, Barbara Boychuk, Jaimi H Greenslade, Sally Aldous, Christopher J Hammett, William A Parsonage, Joanne M Deely, John W Pickering, Louise Cullen |
Abstract |
The emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP) facilitates low-risk ED chest pain patients early to outpatient investigation. We aimed to validate this rule in a North American population. We performed a retrospective validation of the EDACS-ADP using 763 chest pain patients who presented to St Paul's Hospital, Vancouver, Canada, between June 2000 and January 2003. Patients were classified as low risk if they had an EDACS <16, no new ischaemia on ECG and non-elevated serial 0-hour and 2-hour cardiac troponin concentrations. The primary outcome was the number of patients who had a predetermined major adverse cardiac event (MACE) at 30 days after presentation. Of the 763 patients, 317 (41.6%) were classified as low risk by the EDACS-ADP. The sensitivity, specificity, negative predictive value and positive predictive value of the EDACS-ADP for 30-day MACE were 100% (95% CI 94.2% to 100%), 46.4% (95% CI 42.6% to 50.2%), 100% (95% CI 98.5% to 100.0%) and 17.5% (95% CI 14.1% to 21.3%), respectively. This study validated the EDACS-ADP in a novel context and supports its safe use in a North American population. It confirms that EDACS-ADP can facilitate progression to early outpatient investigation in up to 40% of ED chest pain patients within 2 hours. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 5 | 29% |
Malaysia | 3 | 18% |
United States | 3 | 18% |
Slovenia | 1 | 6% |
New Zealand | 1 | 6% |
Unknown | 4 | 24% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 6 | 35% |
Members of the public | 6 | 35% |
Scientists | 5 | 29% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 59 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 14% |
Student > Bachelor | 7 | 12% |
Student > Postgraduate | 6 | 10% |
Professor > Associate Professor | 4 | 7% |
Student > Doctoral Student | 4 | 7% |
Other | 12 | 20% |
Unknown | 18 | 31% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 26 | 44% |
Nursing and Health Professions | 4 | 7% |
Psychology | 2 | 3% |
Physics and Astronomy | 1 | 2% |
Engineering | 1 | 2% |
Other | 0 | 0% |
Unknown | 25 | 42% |