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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 Family Practice, December 2014
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  • Good Attention Score compared to outputs of the same age (72nd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (60th percentile)

Mentioned by

twitter
6 tweeters

Citations

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3 Dimensions

Readers on

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34 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 Family Practice, 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¿.

Twitter Demographics

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

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
France 1 3%
Unknown 33 97%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 9 26%
Student > Ph. D. Student 7 21%
Student > Postgraduate 3 9%
Student > Bachelor 3 9%
Other 2 6%
Other 5 15%
Unknown 5 15%
Readers by discipline Count As %
Medicine and Dentistry 18 53%
Nursing and Health Professions 6 18%
Psychology 1 3%
Social Sciences 1 3%
Computer Science 1 3%
Other 1 3%
Unknown 6 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 4. 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 December 2016.
All research outputs
#3,424,247
of 12,373,620 outputs
Outputs from BMC Family Practice
#486
of 1,233 outputs
Outputs of similar age
#73,563
of 273,351 outputs
Outputs of similar age from BMC Family Practice
#70
of 180 outputs
Altmetric has tracked 12,373,620 research outputs across all sources so far. This one has received more attention than most of these and is in the 72nd percentile.
So far Altmetric has tracked 1,233 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.1. This one has gotten more attention than average, scoring higher than 59% 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 273,351 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.
We're also able to compare this research output to 180 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 60% of its contemporaries.