Accuracy of Emergency Department Chest Pain Patients' Reporting of Coronary Disease History

Area of Science:

• Cardiology
• Emergency Medicine
• Health Services Research

Background:

• Accurate patient history is crucial for emergency department (ED) risk stratification of chest pain.
• Patient recall of coronary artery disease (CAD) and diagnostic testing history can be unreliable.
• Understanding discrepancies in reported vs. recorded medical history is vital for improving care.

Purpose of the Study:

• To evaluate the accuracy of patient self-reporting of coronary artery disease (CAD) history in an emergency department setting.
• To identify factors associated with discrepancies between patient-reported CAD status and electronic medical record data.
• To assess the reliability of patient recall for prior acute myocardial infarction (AMI).

Main Methods:

• Prospective enrollment of adult ED patients presenting with chest pain.
• Structured patient surveys on CAD history and prior testing.
• Structured chart review of electronic medical records for CAD diagnoses, interventions, and test results.
• Statistical analysis using Chi-square and logistic regression.

Main Results:

• Approximately 43% of patients inaccurately reported not having CAD when records indicated otherwise (CAD+).
• Older age was associated with more accurate reporting of the absence of CAD.
• No significant association was found between reporting inaccuracies and female gender, Hispanic ethnicity, income, education, or insurance status.
• 7.2% of patients with a prior acute myocardial infarction (AMI) reported no history of AMI.

Conclusions:

• Patients, particularly from socioeconomically disadvantaged and Hispanic backgrounds, demonstrate poor recall of their coronary artery disease (CAD) medical history.
• Inaccurate self-reporting of CAD status poses a challenge for accurate risk stratification in the ED.
• Further research is needed to improve methods for obtaining accurate patient histories in the ED.