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Fam Pract. 1992 Jun;9(2):149-53.

Evaluating patients with chest pain using classification and regression trees.

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Flemish Institute of General Practice, State University of Limburg, Maastricht, Netherlands.


We collected data on 320 patients complaining to their general practitioner of a new episode of chest pain, discomfort or oppression. Relationships were examined between initial signs and symptoms and a follow-up diagnosis after a period of 2 weeks to 2 months. The data were analysed with CART, a statistical decision theory software package. In our first run, the number of misclassifications by CART was 56%. After regrouping of the data and diagnostic categories, there were 37% misclassifications. The most discriminating variable turned out to be pain on palpation. When comparing each of five diagnostic groups to all others, we found a positive predictive value of 27% for gastrointestinal diseases, 72% for cardiovascular disorders, 69% for respiratory diseases, 58% for psychopathology and 73% for chest wall pathology. The CART methodology needs further investigation and testing before any clinical application will be possible in general practice.

[Indexed for MEDLINE]

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