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Investigators conducted an observational study in four emergency departments to determine costs and radiation doses in the evaluation of patients with “ultralow-risk” chest pain and dyspnea. Ultralow risk was defined as <2.5% likelihood of having pulmonary embolus (PE) or acute coronary syndrome (ACS), as determined by the computerized method of attribute matching (NEJM JW Emerg Med May 27 2014). One of the investigators owns stock in the company that makes attribute matching software.
The software estimated that 27% of the 840 patients had ultralow likelihood of either diagnosis; no one in this subgroup had a diagnosis of PE or ACS within 90 days. In the ultralow-risk subgroup, median chest radiation exposure was 0.06 mSv and the median vis…