Dellen, Sietske van (2012) De gestructureerde cardiale anamnese zorgt voor standaardisatie en de uitkomst hiervan voorspelt coronaire pathologie. thesis, Medicine.
Full text available on request.Abstract
Coronary artery disease is a disorder with a high incidence and prevalence. One of the manifestations of this disease is the occurrence of acute coronary syndrome (ACS). Differentiation between patients with and without ACS is very important so that both the proper diagnostics and treatment can be given to patients with ACS (leading to lower mortality), and on the other hand patients without ACS can be protected against overtreatment and diagnostics. In this study we focus on the structured history as used in the department of cardiology in the UMCG. When a patient with chest pain visits the emergency room he will be classified by the physician as atypical, uncertain or typical for ACS. This corresponds to a low, medium or high risk of getting ACS. We look at the follow-up of these patients one year after their visit to the emergency room. In this way we want to see if the structured history is a good predictor of coronary pathology. Subsequently, we looked at two other methods of estimating the risk of ACS: the working diagnosis and the HEART-score. For these methods we also analyzed the follow-up. We analyzed which methodology most appropriate distinguishes between whether or not to prevent cardiac events one year after the visit to the emergency room. A total of 1072 patients were included, of which 33.8% as atypical, 40.4% as uncertain and 25.8% as typical for ACS. Analysis showed that a very small proportion of patients with ACS are missed (3.6%), which means that the negative predictive value of the structured history is high. On the other hand, many patients are exposed to additional cardiac diagnostics and treatment. There is to be gained in the reduction of diagnostics and treatment. When comparing the different methods for risk assessment by means of ROC curves revealed that de AUCs are comparable
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Tio, Dr. R.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/892 |
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