A Multi-Institutional Analysis From Standardized Clinical Assessment and Management Plans (SCAMPs®) the Pediatric Health Information Systems Database and the National Ambulatory Medical Care Survey

摘要

We conducted a study to assess test characteristics of red-flag criteria for identifying cardiac-disease-causing-chest-pain and technical-charges of low-probability referrals. Accuracy of red-flag criteria was ascertained through study of chest pain SCAMPs® data. Patients were divided into: Group1 (concerning clinical elements) and Group2 (without). We compared incidence of cardiac-disease-causing-chest-pain between these two-groups. Technical-charges of Group2 were analyzed using PHIS Database. Potential savings for the US population was estimated using NAMSC. 52% of subjects formed Group1. Cardiac-disease-causing-chest-pain was identified in 8/1,656 (0.48%). No heart disease was identified in patients in Group2 (p=0.03). Applying red-flags in determining need for referral identified patients with cardiac-disease-causing-chest-pain with 100% sensitivity. Median technical-charges for Group2, over a 4-year-period, were US2014$775,559. Eliminating cardiac testing of low-probability referrals would save US2014$3,775,182 in technical charges annually. Red-flag criteria were an effective screen for children with chest pain. Eliminating cardiac testing in children without red-flags for referral has significant technical-charge savings.