Prospective evaluation of an EDB-based diagnostic program to be used in patients admitted to hospital with acute chest pain.

A recently designed computer based decision support system (DSP), almost exclusively based on case history data, was developed to facilitate immediate differentiation between patients with and without urgent need for coronary care unit (CCU) transferral from the emergency room, and additionally to distinguish between patients with and without acute myocardial infarction (MI). One-year's prospective testing in a consecutive series of 1252 patients with acute chest pain revealed that the DSP, used in addition to ECG and clinical examination, demonstrated a sensitivity of 96% in the detection of patients in need of CCU observation (MI-sensitivity of 98%), and a specificity of 56% in excluding patients who were not in need of CCU observation. The proportion of referrals to the CCU judged to be unnecessary was only 17% of the total number of patients seen in the emergency room.