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Journal Club: Are Those Coronaries Safe for Discharge?

1. Singer AJ et al. Missed myocardial infarctions in ED patients prospectively categorized as low risk by established risk scores. Am J Emerg Med. 2017 doi: 10.1016/j.ajem.2017.01.003.

2. Than M et al. Development and validation of the Emergency Department Assessment of Chest pain Score and 2 h accelerated diagnostic protocol. Emerg Med Australas. 2014. doi: 10.1111/1742-6723.12164

The articles discussed this month in journal club focused on various clinical decision tools which EM physicians may use to risk stratify patients who present to the ED with chest pain. Our first article looked at the development of the EDACS score. This study found the EDACS tool to be very sensitive (99-100%) for identifying low risk chest pain. Our second article compared various chest pain tools against each other including EDACS, HEART, TIMI, GRACE. This article found that EDACS had the best sensitivity and specificity for identifying patients who were low risk for major adverse cardiac event; However, when compared with the HEART score, we did not find that EDACS was as intuitive to apply, and lacked the general recognition that the HEART score has, which can give it more weight when discussing with consultants or admitting teams.

Journal Club Discussion Leader: Meghan Leary, MD (PGY-2)

2019-2020 Academic Year Journal Club Leaders: Sarah Balog, DO (PGY-3); Rose Solomon, MD (PGY-2); David Andonian, MD (Faculty Advisor)

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