New EKG machine helps make decisions
EKG add-on is a real-time predictive instrument
On its way is a device that will quickly identify chest pain patients who are most likely to benefit from thrombolytic therapy so that treatment can be initiated as rapidly as possible. Physicians currently base thrombolysis decisions on EKG results and clinical findings.
This new device will do the same but faster and in a more precise, systematic way. Three factors affect the withholding of thrombolytic therapy: Delay on the part of the patient in seeking care, failure to recognize suitable candidates, and fear of complications.
Computerized decision making
The new computerized decision-making aid will be built into a standard EKG machine. Based on the patient's reading and other clinical information supplied by the physician, it will print out predictions regarding the probability of specific outcomes whether therapy is administered. Armed with the information, the ED physician can estimate if the patient will benefit from thrombolytics.
After basic features of a clinical presentation are entered, the device will estimate the patient's probabilities from zero to 100% of having a myocardial infarction within 48 hours, of dying within 30 days, and of dying within one year. The printout will also contain information regarding complications of therapy, such as hemorrhagic stroke and major bleeding.
The study leading to the development of the EKG add-on was funded by the Agency for Health Care Policy and Research in Rockville, MD, and a follow-up is in the works that will test the clinical impact of making this thrombolytic predictive instrument available in EDs.
Reference
1. Selker HP, Griffith JL, Beshansky JR, et al. Patient-specific predictions of outcomes in myocardial infarction for real-time emergency use: A thrombolytic predictive instrument. Ann Intern Med 1997; 127:538-556.
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