Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis.
BACKGROUND: Chest pain is an initial symptom for several minor diseases but acute myocardial infarction (AMI) should not be missed. AIM: To assess the influence of initial diagnosis and degree of certainty of this initial diagnosis on the referral decision and the referral method (urgent-non-urgent...
| Main Authors: | , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2009
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| _version_ | 1797058780544892928 |
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| author | Bruyninckx, R Van den Bruel, A Aertgeerts, B Van Casteren, V Buntinx, F |
| author_facet | Bruyninckx, R Van den Bruel, A Aertgeerts, B Van Casteren, V Buntinx, F |
| author_sort | Bruyninckx, R |
| collection | OXFORD |
| description | BACKGROUND: Chest pain is an initial symptom for several minor diseases but acute myocardial infarction (AMI) should not be missed. AIM: To assess the influence of initial diagnosis and degree of certainty of this initial diagnosis on the referral decision and the referral method (urgent-non-urgent) in patients contacting their GP with chest pain. STUDY DESIGN: Observational study. SETTING: The study was performed in a sentinel network of general practices in Belgium, covering almost 1.6% of the population. SUBJECTS: All patients attending their GP and complaining of chest pain during 2003. METHOD: The relationships were reported as proportions and in odds ratios (OR) with their 95% confidence intervals. RESULTS: 1996 patients were included (men 52%). Men were referred more often (OR = 1.44; 95% CI: 1.13-1.82). Age shows no relation to referral (OR = 1.06; 95% CI: 0.83-1.35) but predicts urgent referral (OR = 1.46; 95% CI: 1.02-2.08). Odds ratios in case of serious heart disease were high with 11.58 (95% CI: 5.72-23.44) when the GP was certain of his diagnosis and 2.96 (95% CI: 1.59-5.51) if not. If the GP was uncertain, in all disease categories 54% (95% CI: 48-59) of the patients were referred non-urgently. CONCLUSION: Referral rates for patients with chest pain were influenced by the initial diagnosis and the degree of certainty of this initial diagnosis. |
| first_indexed | 2024-03-06T19:55:10Z |
| format | Journal article |
| id | oxford-uuid:255237cf-7c92-4756-8011-0edc0becb53f |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:55:10Z |
| publishDate | 2009 |
| record_format | dspace |
| spelling | oxford-uuid:255237cf-7c92-4756-8011-0edc0becb53f2022-03-26T11:55:02ZWhy does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:255237cf-7c92-4756-8011-0edc0becb53fEnglishSymplectic Elements at Oxford2009Bruyninckx, RVan den Bruel, AAertgeerts, BVan Casteren, VBuntinx, F BACKGROUND: Chest pain is an initial symptom for several minor diseases but acute myocardial infarction (AMI) should not be missed. AIM: To assess the influence of initial diagnosis and degree of certainty of this initial diagnosis on the referral decision and the referral method (urgent-non-urgent) in patients contacting their GP with chest pain. STUDY DESIGN: Observational study. SETTING: The study was performed in a sentinel network of general practices in Belgium, covering almost 1.6% of the population. SUBJECTS: All patients attending their GP and complaining of chest pain during 2003. METHOD: The relationships were reported as proportions and in odds ratios (OR) with their 95% confidence intervals. RESULTS: 1996 patients were included (men 52%). Men were referred more often (OR = 1.44; 95% CI: 1.13-1.82). Age shows no relation to referral (OR = 1.06; 95% CI: 0.83-1.35) but predicts urgent referral (OR = 1.46; 95% CI: 1.02-2.08). Odds ratios in case of serious heart disease were high with 11.58 (95% CI: 5.72-23.44) when the GP was certain of his diagnosis and 2.96 (95% CI: 1.59-5.51) if not. If the GP was uncertain, in all disease categories 54% (95% CI: 48-59) of the patients were referred non-urgently. CONCLUSION: Referral rates for patients with chest pain were influenced by the initial diagnosis and the degree of certainty of this initial diagnosis. |
| spellingShingle | Bruyninckx, R Van den Bruel, A Aertgeerts, B Van Casteren, V Buntinx, F Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title | Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title_full | Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title_fullStr | Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title_full_unstemmed | Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title_short | Why does the general practitioner refer patients with chest pain not-urgently to the specialist or urgently to the emergency department? Influence of the certainty of the initial diagnosis. |
| title_sort | why does the general practitioner refer patients with chest pain not urgently to the specialist or urgently to the emergency department influence of the certainty of the initial diagnosis |
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