122 – – sensitivity of 99%, specificity of 12.9%, and a negative predictive value of 99.8%. Again, while conducting such a study may not appeal to everyone, the results from such investigations do impact everyday patient care. If the above two examples haven’t convinced you clinical research directly impacts patient care, consider the following case: A 45-year-old male presents to the ED with chest pain of 2.5-h duration, radiating to the left arm, associated with diaphoresis, relieved by sublingual nitroglycerin in the ambulance, and rated 5/10. Family history is unknown. What blood test will you order? The troponin story [3]: 855 patients with symptoms of acute myocardial ischemia within 12 h of onset had serum troponin T, CK-MB, and ECG done and analyzed in blinded fashion. Logistic regression was used to assess the usefulness of baseline levels of troponin T and CK-MB vs. ECG findings (ST-segment elevation, ST-segment depression, T-wave inversion, or the presence of confounding factors that impair the detection of ischemia). On admission, 289 of 801 patients with base-line serum samples had elevated troponin T. Mortality within 30 days was significantly higher in these patients than in patients with lower levels of troponin T (11.8% vs. 3.9%, P < 0.001). Troponin T levels remained significantly predictive of 30-day mortality in a model that contained ECG categories and CK-MB levels (chi-square = 9.2, P= 0.027). The authors of the study concluded that cardiac troponin T level is a powerful, independent risk marker in patients who present with acute myocardial infarction. Int J Emerg Med (2008) 1:121–122 – Today, most clinicians routinely use this serum marker, perhaps not thinking about its origins from a research study. So, why care about clinical research? Clinical research is the way in which we can scientifi- cally study patient outcomes and thus deliver evidence- based care. Our ED is our laboratory—where we are continually gathering, classifying, and analyzing data. While basic science and animal studies can provide important clues to the underlying pathophysiology of many human ailments, some nuances of human disease are not translatable from these models. Referred to as “the youngest science” by Lewis Thomas, the wonders of modern medicine are a direct result of medical research. Being involved in research offers the clinician the satisfac- tion of discovery and contributing to the care of those beyond the reach of her touch. “The real voyage of discovery consists not in seeking new landscapes, but in having new eyes.” -Marcel Proust References 1. Stiell et al (1993) Decision rule for radiography in acute ankle injuries: Refinement and prospective validation. JAMA 269 (9):1127–1132, Mar 3 2. Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI (2000) Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. N Engl J Med 343:94–99 3. Ohman EM, Armstrong PW, Christenson RH, Granger CB, Katus HA, Hamm CW, O’Hanesian MA, Wagner GS, Kleiman NS, Harrell FE Jr, Califf RM, Topol EJ (1996) Cardiac troponin T levels for risk stratification in acute myocardial ischemia. GUSTO IIA Investigators. N Engl J Med 335(18):1333–1341, Oct 31