Tool that evaluates the utility of various tests for coronary artery disease, saving time by allowing non-cardiologists to order an appropriate test.
There are many clinical situations where a patient needs to be evaluated for coronary artery disease (emergency room, pre-transplant surgery, etc.). Non-cardiologists often lack the expertise needed to select the correct test. A cardiologist usually orders the test, but the process can be inefficient due to delays caused by waiting for the cardiologist to see the patient, schedule the test, and then to review the results when they become available.
This web-based application allows non-cardiologists to decide which cardiac tests should be ordered. If the appropriate test is ordered in advance, the results can be available when the patients are first seen by the cardiologist, or in some cases, eliminate the need for the patient to be seen. This would expedite a number of workflows, such as patient disposition in the ER or listing for transplant. Improved testing may also improve the diagnosis of a patient with chest pain in an emergency room.
The user answers a survey of 15 clinical questions that are adapted for different clinical contexts. Each question has an “info” button that provides more information. Based on the answers, utility scores are assigned to each of 10 possible tests. 10 points, color-coded green, means there are no drawbacks to using that test. 1-9 points, color-coded yellow, means that the test may be reasonable, but with concerns. 0 points, color-coded red, indicates that the test should not be used. Rationales for the assigned scores that help inform the provider’s decision are available with one click. Clicking on the test name provides information about the test. Results can be pended or saved, and can be recalled later with the patient’s MRN.
The figure shows a sample screen of the decision support tool. On the left are clinical questions that the health care provider must answer. On the right are results showing the color-coded numerical scores for each test. The rationale for a given test is shown below the test name. [Figure origin: Obtained from inventor’s PowerPoint “Coronary Artery Disease Decision Support Tool” (Gomberg, 2020).
- 92% agreement with decisions made by attending cardiologists in a retrospective study
- Allows non-cardiologists to make informed decisions
- Expedites decision regarding listing for transplant
- Improves workflow efficiency with faster scheduling of tests
Stage of Development:
IND received, with tests ongoing at Penn