Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .
A computer based telemedicine protocol to predict acute coronary syndrome in patients with chest pain at home.
The decision to admit a patient to a coronary care unit for acute coronary syndrome ( ACS ) has serious medical and financial consequences . In this study , we aim ed to develop a computer program to predict the existence of ACS in patients with chest pain at home ; it is intended that patients will be able to access the program via the website to test its validity . This study proceeded in two phases . In the first phase , a computer-based decision protocol was developed using recursive-partitioning analysis to predict ACS in 250 patients with chest pain on the basis of their historical data . In the second phase , this protocol was tested in 115 patients for diagnosis of ACS prospect ively . Thirty-two of the patients answered the algorithm questions on the website . All of the patients who visited the website of this study were advised to go to the emergency department . Although the algorithm showed the presence of ACS in 82 of 115 patients , 60 of 115 patients were diagnosed as having ACS in the emergency department ( n = 55 ) or at follow-up . The agreement between the diagnosis of the algorithm and the true diagnosis was moderate and statistically significant ( Kappa coefficient 0.61 , P < 0.001 ) . The sensitivity of the algorithm was 100 % , although its specificity was 60 % . The accuracy of the algorithm in diagnosing ACS was 81 % . The algorithm diagnoses patients with ACS at a high ratio and decreases the number of patients being unnecessarily admitted to the emergency with non-ACS
Similarly , there was no clear evidence of effect for cardiovascular risk factors , although again the number of studies reporting these was small .
There was some evidence for beneficial effects on HRQOL , dietary outcomes , and physical activity , although firm conclusions can not yet be made .
The effects on healthcare utilisation and cost-effectiveness are also inconclusive , and trials are yet to measure the impact of  Internet interventions on compliance with medication .
BACKGROUND The Internet could provide a means of delivering secondary prevention programmes to people with coronary heart disease ( CHD ) .
OBJECTIVES To determine the effectiveness of Internet-based interventions targeting lifestyle changes and medicines management for the secondary prevention of CHD .