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Paperchase #3 - CV testing and Outcomes in Chest Pain

Andrew Buelt, DO and Joe Weatherly, DO
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No me gusta!

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Our paperchasers looked at this study and concluded that exercise stress testing is overused in the low risk chest pain patient who has no EKG changes and no troponin rise.

 

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Jay Jerome -

I can't tell what I am supposed to do with this information....
The only thing I remember from the reviewers was...NO change in practice management for fear of litigation.

Heidi J., MD -

Hi Jay - yes, it is ambiguous. There is little evidence supporting much of the CV testing we do, BUT fear of litigation and/or deviating from your practice community's standard of care will stop many of us from changing our practice. Andrew's a cowboy, so this is definitely changing his practice, Joe's giving it serious thought and will likely change, and I'm waiting for more studies before I become the local rebel. Same data, 3 dif't impacts on practice. Gotta love EBM.

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It's Bloody Halloween! Full episode audio for MD edition 187:22 min - 88 MB - M4AHippo Primary Care RAP - October 2017 Summary 2 MB - PDF

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