Predictive Instrument to Improve Coronary-Care-Unit Admission Practices

To the Editor: As a practicing emergency room physician, I must confess to some discomfort with the data presented by Pozen et al. in the May 17 issue.* In Table 2, they report a false negative diagnosis rate of 2.5 per cent during the control period and 3.3 per cent during the experimental period. Since the experimental group contained 1288 patients, use of the predictive instrument resulted in 10 more patients who had infarcts being sent home than would have been sent home without the instrument (1288 X 0.008 = 10.3). That may not be significant to a statistician, but . . . No extract is available for articles shorter than 400 words.