Medical Decision-Making Applied to the Diagnosis of Coronary Artery Disease

Background We intend to examine whether the COVID-19 outbreak influences medical decision-making (MDM) among Non-COVID patients. Method We recruit 287 patients who admit to ER department due to cardiovascular complaints. Anxiety level was measured using three questionnaires (GAD-7, Beck Inventory, and the cardiac anxiety questionnaire). A fourth survey was designed to assess MDM considerations. Results 64% of patients were male (median age 54). Almost half of the patients were found to have moderate to severe levels of anxiety.79.3% of patients reported that the outbreak influenced their MDM. 44.5% of patients sought medical care 2-3 from the onset of symptoms. Coronary artery disease was found in only 26 patients (9.1%). Almost half of the patients stated that they would have gone earlier if not for the current pandemic. Conclusion Non-COVID patients seeking medical care had a high anxiety level that directly affected decision-making and put them at unnecessary risk.

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THE USE OF A GENE EXPRESSION SCORE WAS ASSOCIATED WITH IMPROVED MEDICAL DECISION MAKING IN THE EVALUATION OF WOMEN PRESENTING WITH SYMPTOMS SUGGESTIVE OF OBSTRUCTIVE CORONARY ARTERY DISEASE: SUMMARY RESULTS FROM TWO AMBULATORY CARE STUDIES IN PRIMARY CARE

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(15)61662-x ◽

2015 ◽

Vol 65 (10) ◽

pp. A1662

Author(s):

Joseph Ladapo ◽

Lee Herman ◽

Bonnie H. Weiner ◽

Brian Rhees ◽

Lon Castle ◽

...

Keyword(s):

Gene Expression ◽

Primary Care ◽

Coronary Artery Disease ◽

Decision Making ◽

Medical Decision Making ◽

Obstructive Coronary Artery Disease ◽

Medical Decision ◽

Artery Disease ◽

Expression Score ◽

Gene Expression Score

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Health Care Analysis on Myocardial Revascularization in Patients with Chronic Coronary Artery Disease: The Multicenter REVASK Study: Design and Protocol

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1721391 ◽

2020 ◽

Author(s):

Andreas Beckmann ◽

Eva-Maria Bitzer ◽

Mareike Lederle ◽

Peter Ihle ◽

Jochen Walker ◽

...

Keyword(s):

Coronary Artery Disease ◽

Health Care ◽

Decision Making ◽

Coronary Artery ◽

Myocardial Revascularization ◽

Care Providers ◽

Chronic Coronary Artery Disease ◽

Care Guideline ◽

Artery Disease

AbstractCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are available for revascularization of coronary artery disease (CAD) with the aims to reduce cardiovascular morbidity and mortality and to improve disease-related quality of life in particular. The German National Care Guideline (NVL-cKHK) on chronic CAD recommends the establishment of so-called heart teams for decision making in myocardial revascularization to improve the quality of care. Preferred recommendations for PCI or CABG are given for different patient subgroups depending on patient characteristics, concomitant diseases, and coronary morphology. The myocardial revascularization study (REVASK) is a noninterventional cohort study on care of patients undergoing PCI or CABG based on retrospective statutory health insurance (SHI) routine data, registry data from the German Cardiac Society (DGK) resp., the German Society for Thoracic and Cardiovascular Surgery (DGTHG), combined with prospective primary data collection from health care providers and patients. The primary goal is to investigate whether and to which extent heart teams, consisting of cardiologists and cardiac surgeons, increase guideline adherence in decision making for myocardial revascularization. Ultimately the study project aims to improve patient care in terms of decision making for appropriate myocardial revascularization. Through the consistent implementation of the German National Care Guideline on chronic Coronary Artery Disease (NVL-cKHK) and the European Guidelines on myocardial revascularization, the reduction of morbidity, mortality and the reduced need for subsequent revascularization procedures are also desirable from a health economics perspective.

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