Hickam D H, Sox H C, Marton K I, Skeff K M, Chin D
Med Decis Making. 1982 Winter;2(4):403-14. doi: 10.1177/0272989X8200200404.
Although previous studies have reported the prevalence of coronary artery disease among patients with typical and atypical angina, criteria for the definition of these chest pain syndromes have not been well described. We studied the implicit criteria used by physicians to classify patients with chest pain. Five internists reviewed the histories of 190 subjects admitted to the hospital for elective coronary arteriography and rated each history as indicating either high or low risk of coronary disease. We applied logistic discriminant analysis to these ratings to create a decision rule for the classification of patients with anginal syndromes. The prevalence of confirmed coronary artery disease in subjects classified by the rule as at high risk was 0.83; the prevalence was 0.57 in subjects classified as at low risk. These prevalences are similar to those found for typical and atypical angina in previous large studies. We conclude that this linear model represents the physicians' decisions and provides criteria for defining anginal pain syndromes in certain settings.
尽管先前的研究报告了典型和非典型心绞痛患者中冠状动脉疾病的患病率，但这些胸痛综合征的定义标准尚未得到充分描述。我们研究了医生用于对胸痛患者进行分类的隐含标准。五位内科医生回顾了190名因择期冠状动脉造影而入院的受试者的病史，并将每份病史评定为提示冠心病高风险或低风险。我们对这些评级应用逻辑判别分析，以创建一个用于对心绞痛综合征患者进行分类的决策规则。根据该规则分类为高风险的受试者中确诊冠状动脉疾病的患病率为0.83；分类为低风险的受试者中患病率为0.57。这些患病率与先前大型研究中典型和非典型心绞痛的患病率相似。我们得出结论，这种线性模型代表了医生的决策，并为在某些情况下定义心绞痛疼痛综合征提供了标准。
