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Concern for acute coronary syndromes (ACS) in patients presenting to the emergency department (ED) with chest pain is common, yet it is unclear whether physician gestalt is accurate enough to rule in or rule out ACS. These authors conducted a secondary analysis of data from a prospective multicenter U.K. study evaluating the diagnostic accuracy of troponin in 1613 adult patients who were deemed by their treating emergency physicians to have chest pain warranting evaluation for ACS.
As part of the primary study, physicians rated the likelihood that the patient had ACS on a 5-point scale, ranging from “definitely not” to “definitely,” after the initial patient assessment. Physicians were given access to the electrocardiogram (ECG) results and,…