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BACKGROUND Patients with acute, undifferentiated chest pain present a frequent diagnostic challenge to clinicians. Clinical features are often used to determine which patients may have acute coronary syndrome (ACS). AIM To identify clinical features that independently predict ACS in patients with acute, undifferentiated chest pain. DESIGN Prospective(More)
OBJECTIVES To establish a chest pain observation unit, monitor its performance in terms of appropriate discharge after assessment, and estimate the cost per patient. METHODS Prospective, observational, cohort study of patients attending a large, city, teaching hospital accident and emergency department between 1 March 1999 and 29 February 2000 with acute(More)
Gardner's Multiple Intelligences theory is presented as a cognitive perspective on intelligence which has profound implications for education in general. More specifically, it has led to the application of eight of these frames to language teaching and learning. In this chapter, we will argue in favour of the application of MIT to the EFL classroom, using(More)
BACKGROUND The chest pain unit (CPU) provides rapid diagnostic assessment for patients with acute, undifferentiated chest pain, using a combination of electrocardiographic (ECG) recording, biochemical markers and provocative cardiac testing. We aimed to identify which elements of a CPU protocol were most diagnostically and prognostically useful. METHODS(More)
OBJECTIVES To measure the effectiveness and cost effectiveness of providing care in a chest pain observation unit compared with routine care for patients with acute, undifferentiated chest pain. DESIGN Cluster randomised controlled trial, with 442 days randomised to the chest pain observation unit or routine care, and cost effectiveness analysis from a(More)
STUDY OBJECTIVES We sought to measure psychologic morbidity and health-related quality of life among patients attending the hospital with acute chest pain both at presentation and 1 month after rigorous assessment for cardiac disease. METHODS Consecutive patients undergoing assessment on the chest pain observation unit of a large, urban emergency(More)
BACKGROUND Chest pain units (CPUs) provide a system of care for patients with acute chest pain that can improve outcomes while reducing health service costs. The Effectiveness and Safety of Chest Pain Assessment to Prevent Emergency Admissions (ESCAPE) multicentre trial was undertaken to determine whether CPUs could be successfully established throughout(More)
OBJECTIVES To determine whether providing an information sheet to patients with acute chest pain reduces anxiety, improves health related quality of life, improves satisfaction with care, or alters subsequent symptoms or actions. DESIGN Single centre, non-blinded, randomised controlled trial. SETTING Chest pain unit of an emergency department. (More)
BACKGROUND Studies from the United States (US) suggest that using a chest pain observation unit (CPOU) saves from $567 to $2,030 per case compared with hospital admission. These savings will only be reproduced in the United Kingdom (UK) if the cost of routine hospital admission is similar. This study aimed to review current practice to determine the(More)