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  1. The use of empiric clinical data in the evaluation of practice guidelines for unstable angina.

    Article - En anglais

    Objective

    - To determine the applicability to emergency department (ED) clinical practice of a nationally disseminated practice guideline on the disposition of patients with a diagnosis of unstable angina, and to determine the potential impact of the guideline on hospital admissions and demand for intensive care beds.

    Design

    - Application of guideline criteria for ED disposition decisions to a validation sample derived from a prospective clinical trial.

    Setting

    - Five hospitals, including 2 urban general teaching hospitals, 2 urban tertiary care university hospitals, and 1 suburban university-affiliated community hospital.

    Patients

    - A consecutive sample of 457 patients who presented with symptoms suggestive of acute cardiac ischemia and who had « unstable angina » or « rule out unstable angina » diagnosed by ED physicians.

    Greater than 90% of eligible patients were enrolled in the clinical trial ; follow-up data sufficient for assignment of a definitive diagnosis were obtained for 99% of subjects.

    Main Outcome Measures

    - Acute myocardial infarction and unstable angina, based on blind review of initial and follow-up clinical data, including cardiac enzyme levels and electrocardiograms.

    After completion of the trial, without knowledge of final diagnosis or outcome, the investigators classified patients into risk groups specified by the unstable angina guideline.

    Results

    (...)

    Mots-clés Pascal : Angor instable, Evaluation, Modèle empirique, Infarctus, Myocarde, Urgence, Service hospitalier, Unité soin intensif, Critère décision, Facteur risque, Recommandation, Homme, Donnée, Disposition pratique, Planification, Appareil circulatoire pathologie, Cardiopathie coronaire, Organisation santé, Myocarde pathologie

    Mots-clés Pascal anglais : Variant angina, Evaluation, Empirical model, Infarct, Myocardium, Emergency, Hospital ward, Intensive care unit, Decision criterion, Risk factor, Recommendation, Human, Data, Practical measure, Planning, Cardiovascular disease, Coronary heart disease, Public health organization, Myocardial disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0055553

    Code Inist : 002B30A04B. Création : 21/05/1997.