New tool to rule out coronary heart disease in primary care

July 05, 2010

A simple new rule can help primary care physicians rule out coronary heart disease in patients with chest pain, states a study published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj100212.pdf.

Chest pain is common, yet it is challenging for primary care physicians to reliably identify serious cardiac disease while protecting patients from unnecessary interventions.

The authors developed a clinical decision rule called the Primary Care CHD Score ("Marburg Heart Score") with five predictors that can be easily identified during a patient's visit: age/gender, known clinical vascular disease, pain worse with exercise, patient assumes cardiac origin of pain and pain not reproduced with palpitation.

"The aim of our study was to develop a simple, valid, and usable prediction score based on signs and symptoms to help physicians rule out coronary heart disease (CHD) in chest pain patients presenting in primary care," write Dr. Stefan Bösner, University of Marburg, Marburg, Germany and coauthors.

In a related commentary (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj100808.pdf, Richard Stevens and Daniel Lasserson of University of Oxford, UK, write "the challenge is correctly identifying and referring the patient with coronary heart disease while minimizing the number of referrals of patients who do not have CHD, to reduce the harm of unnecessary investigation and burden on healthcare resources." The authors suggest this decision rule shows promise for improving the diagnosis of CHD.
-end-


Canadian Medical Association Journal

Related Primary Care Articles from Brightsurf:

Six ways primary care "medical homes" are lowering health care spending
New analysis of 394 U.S. primary care practices identifies the aspects of care delivery that are associated with lower health care spending and lower utilization of emergency care and hospital admissions.

Continuity of English primary care has worsened with GP expansions
A new study published by the British Journal of General Practice has found that patients' abilities to see their preferred GP has fallen greater in English practices that have expanded, compared with those that stayed about the same size.

Primary care office-based vs telemedicine care visits during COVID-19 pandemic
This observational study quantified national changes in the volume, type and content of primary care delivered during the COVID-19 pandemic, especially with regard to office-based visits compared with telemedicine encounters.

Expenditures for primary care may affect how primary care is delivered
This study looks at trends in out-of-pocket and total visit expenditures for visits to primary care physicians.

Primary care clinicians drove increasing use of Medicare's chronic care management codes
To address the problem of care fragmentation for Medicare recipients with multiple chronic conditions, Medicare introduced Chronic Care Management (CCM) in 2015 to reimburse clinicians for care management and coordination.

Primary care at a crossroads: Experts call for change
Primary care providers have experienced a rise in responsibilities with little or no increase in the time they have to get it all done, or reduction in the number of patients assigned to them.

Primary care physicians during the COVID-19 epidemic
Scientists from the University of Geneva has analysed clinical data from more than 1,500 ambulatory patients tested for COVID-19.

The five phases of pandemic care for primary care
The authors present a roadmap for necessary primary care practice transformations to care for patients and communities during the COVID-19 pandemic.

Women almost twice as likely to choose primary care as men
Analysis of osteopathic medical school survey data reveals women are 1.75 times more likely to choose primary care than men, according to a study in The Journal of the American Osteopathic Association.

Spending on primary care vs. other US health care expenditures
National health care survey data were used to assess the amount of money spent on primary care relative to other areas of health care spending in the US from 2002 to 2016.

Read More: Primary Care News and Primary Care Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.