Use of Shared Decision-Making Can Decrease Testing in Patients with Chest Pain

Given potential differences in patients' and clinicians' goals of care and tolerance to risk, shared decision-making is important in emergency medicine. In a previous multicenter trial, researchers demonstrated that patients with low-risk chest pain randomized to a decision aid intervention were less likely to be admitted for cardiac testing than those randomized to usual care (NEJM JW Emerg Med Jan 2017 and BMJ 2016; 355:i6165). In the intervention group, clinicians used a decision aid to inform patients of their personalized 45-day risk for acute coronary syndrome (presented with a pictograph and simple prose) and had them share in deciding the management approach. In this planned secondary analysis, the researchers evaluated healthcare u…