Safety and efficiency of a chest pain diagnostic algorithm with selective outpatient stress testing for emergency department patients with potential ischemic chest pain
Diagnostic tests in the ED are often used to screen many patients for the possibility of severe illness, e.g. ACS in chest pain, SAH in headache, dementia in the elderly. We typically wish to rule-out a condition and such testing must be highly sensitive (SnOut) but will have false positives, e.g Troponin, CT Head, Ottawa-3DY. In contrast, specialty services may be more interested in ruling in a condition definitively using tests that are highly specific (SpIn), e.g. coronary angiography, CT angiography of the brain, a battery of cognitive tests.