Grant: Project Grant

Canadian emergency departments see over 600,000 patients per year with symptoms of a possible heart attack. Of these, less than 15% have a heart-related cause for their symptoms. Many patients undergo additional heart testing after a heart attack has been ruled out. But, because relatively few have a cardiac cause for their symptoms, few patients actually benefit from testing. Doctors sometimes use risk prediction tools based on risk factors for heart disease to help decide which patients should undergo additional cardiac testing. However, existing risk prediction tools--and the doctors' individual judgment--don't always perform well on patients in emergency departments. Many very low-risk patients undergo unnecessary testing, while some high-risk patients end up being under-investigated and under-treated. The goal of this research program is to develop better risk-prediction tools to help emergency doctors and patients make personalized decisions about whether an patient should undergo additional cardiac testing after a heart attack has been ruled out, and whether that testing needs to happen immediately or at a more convenient time as an outpatient. The precision risk prediction tools that we will develop will ensure that the right patients get the right test at the right time, in order to improve patient outcomes and ensure that health system resources are used wisely.