Physicians Estimates of the Probability of Myocardial Infarction in Emergency Boom Patients with chest Pain

William M. Tierney, John Fitzgerald, Ross Mchenry, Bruce J. Roth, Bruce Psaty, David L. Stump, F. Kim Anderson

Research output: Contribution to journalArticle

96 Scopus citations

Abstract

To evaluate the ability of emergency room physicians to estimate the probability of myocardial infarction in patients with acute chest pain, the authors gathered historical, physical, and electrocardiographic information from 492 patients at the time of their presentation. The physicians admitted 30% of them to intensive care: 53 of the 61 patients with infarctions (sensitivity = 87%) and 96 of the 431 without infarctions (specificity = 78%). Overall, 36% of those admitted had infarctions. The physicians numeric estimate of the probability of infarction was a good univariate discriminator of infarction, as demonstrated by Receiver Operator Characteristics analysis, and, as indicated by their actual operating point, they seemed to maximize the accuracy of patient classification rather than sensitivity or specificity. Logistic regression analysis identified the physicians probability estimate as the strongest multivariate predictor of infarction, considering all other clinical information available.

Original languageEnglish (US)
Pages (from-to)12-17
Number of pages6
JournalMedical Decision Making
Volume6
Issue number1
DOIs
StatePublished - Feb 1986

Keywords

  • myocardial infarction
  • prediction
  • probability

ASJC Scopus subject areas

  • Health Policy

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    Tierney, W. M., Fitzgerald, J., Mchenry, R., Roth, B. J., Psaty, B., Stump, D. L., & Anderson, F. K. (1986). Physicians Estimates of the Probability of Myocardial Infarction in Emergency Boom Patients with chest Pain. Medical Decision Making, 6(1), 12-17. https://doi.org/10.1177/0272989X8600600103