Annals of emergency medicine
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Multicenter Study Clinical Trial
Clinician Gestalt Estimate of Pretest Probability for Acute Coronary Syndrome and Pulmonary Embolism in Patients With Chest Pain and Dyspnea.
Pretest probability helps guide diagnostic testing for patients with suspected acute coronary syndrome and pulmonary embolism. Pretest probability derived from the clinician's unstructured gestalt estimate is easier and more readily available than methods that require computation. We compare the diagnostic accuracy of physician gestalt estimate for the pretest probability of acute coronary syndrome and pulmonary embolism with a validated, computerized method. ⋯ Compared with a validated machine-based method, clinicians consistently overestimated pretest probability but on receiver operating curve analysis were as accurate for pulmonary embolism but not acute coronary syndrome.
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We explore what emergency physicians with access to health information exchange have to say about it and strive to better understand the factors affecting their use of it. ⋯ The emergency physicians reported that health information exchange disrupted their workflow and was less than desirable to use. The health information exchange systems need to adapt to the needs of the end user to be both useful and useable for emergency physicians.