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Chest pain out-of-hours – an interview study of primary care physicians’ diagnostic approach, tolerance of risk and attitudes to hospital admission

Overview of attention for article published in BMC Primary Care, December 2014
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (82nd percentile)
  • Good Attention Score compared to outputs of the same age and source (68th percentile)

Mentioned by

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1 policy source
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6 X users

Citations

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9 Dimensions

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41 Mendeley
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Title
Chest pain out-of-hours – an interview study of primary care physicians’ diagnostic approach, tolerance of risk and attitudes to hospital admission
Published in
BMC Primary Care, December 2014
DOI 10.1186/s12875-014-0207-4
Pubmed ID
Authors

Robert Anders Burman, Erik Zakariassen, Steinar Hunskaar

Abstract

BackgroundAcute chest pain constitutes a considerable diagnostic challenge outside hospitals. This will often lead to uncertainty in choosing the right management, and the physicians¿ approach may be influenced by their knowledge of diagnostic measures and their tolerance of risk. The aim of this study was to investigate primary care physicians¿ diagnostic approach, tolerance of risk and attitudes to hospital admission in patients with acute chest pain out-of-hours in Norwegian primary care.MethodsData were registered prospectively from four Norwegian casualty clinics. Data from structured telephone interviews with 100 physicians shortly after a consultation with a patient presenting at the casualty clinic with ¿chest pain¿ were analysed. Tolerance of risk was measured by the Pearson Risk Scale and the Tolerance of Risk Scale, the latter developed for this study.Results¿Patient history and symptoms¿ was considered the most important, and ¿negative ECG¿ and ¿effect of sublingual nitroglycerine¿ the least important aspects in the diagnostic approach. There were no significant differences in length of experience or gender when testing ¿risk avoiders¿ against the rest. Almost all physicians felt that their risk assessment out-of-hours was reasonably good, and felt reasonably safe, but only 50% agreed with the statement ¿I don¿t worry about my decisions after I¿ve made them¿. Concerning chest pain patients only, 51% of the physicians were worried about complaints being made about them, 75% agreed that admitting someone to hospital put patients in danger of being ¿over-tested¿, and 51% were more likely to admit the patient if the patient herself wanted to be admitted.ConclusionsPhysicians working out-of-hours showed considerable differences in their diagnostic approach, and not all physicians diagnose patients with chest pain according to current guidelines and evidence. Continuous medical education must focus on the diagnostic approach in patients with chest pain in primary care and empowerment of physicians through training and emphasis on risk assessment and ¿tolerance of risk¿.

X Demographics

X Demographics

The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 41 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 2%
Unknown 40 98%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 10 24%
Student > Ph. D. Student 7 17%
Student > Bachelor 3 7%
Other 3 7%
Unspecified 3 7%
Other 8 20%
Unknown 7 17%
Readers by discipline Count As %
Medicine and Dentistry 18 44%
Nursing and Health Professions 6 15%
Unspecified 3 7%
Business, Management and Accounting 1 2%
Psychology 1 2%
Other 3 7%
Unknown 9 22%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 8. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 15 February 2017.
All research outputs
#4,807,943
of 25,373,627 outputs
Outputs from BMC Primary Care
#672
of 2,359 outputs
Outputs of similar age
#61,792
of 360,039 outputs
Outputs of similar age from BMC Primary Care
#9
of 29 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. Compared to these this one has done well and is in the 81st percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,359 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 7.7. This one has gotten more attention than average, scoring higher than 71% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 360,039 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 82% of its contemporaries.
We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.