Clinical judgement, combined with an electrocardiogram (ECG) and blood test on arrival, is effective in reducing unnecessary hospital admissions for chest pain, the most common reason for emergency hospital admission, according to a UK study.
The latest research assessed the diagnostic accuracy of emergency doctors’ clinical judgement for acute coronary syndromes – both alone and in combination with the tests available on arrival – ECG and a blood test which detects a protein called troponin.
The results showed that for patients who are suspected to have an ACS, clinical judgement cannot be relied upon by itself to rule out or rule in that diagnosis. However, when combined with an ECG and troponin test clinical judgement appeared to be an effective tool and the results suggest that at least 25 per cent of patient admissions could have avoided.
The study also suggested that this was the case regardless of whether the clinician was a consultant or junior doctor.
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