The National Institute for Health and Care Excellence (NICE) CG95 clinical guideline on @entity662 of recent onset was published in 2010. There is debate over whether the proposed strategy improves @entity1 care and its implications on service costs. Following a six-month pilot, 472 consecutive @entity1 records were audited for pre-test probability of significant @entity453 , investigations performed and outcomes. Low- and moderate-risk @entity1 had an unexpectedly low rate of @entity301 and revascularisation. Computerised tomography coronary angiography (CTCA) and stress echocardiography performed similarly, though the latter was more resource intensive. High-/very high-risk @entity1 frequently required revascularisation and greater than 10% of each group had prognostically significant disease, going against the recommendation that very high risk @entity1 do not undergo angiography. There were frequent protocol deviations and training clinic staff in the new approach was challenging. In conclusion, implementing NICE CG95 is feasible but presents challenges. Staff require training to follow the protocol consistently. Functional testing had no benefits over anatomical testing with CTCA, which may allow cost savings in some departments.

Implementation of NICE clinical guideline 95 on XXXX of recent onset: experience in a district general hospital.

@entity662 :: ('MESH:D002637', 'Disease') :: ['chest pain'] @entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease'] @entity301 :: ('MESH:D003327', 'Disease') :: ['coronary disease']
@entity662 :: (MESH:D002637,Disease) :: ['chest pain']
