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Table 2 Comparison of findings reported by physician histories and computer histories for 8 patients presenting to their physicians with a chief complaint of chest pain and for whom there were significant discrepancies between physician and computer histories of the present illness

From: Underutilization of information and knowledge in everyday medical practice: Evaluation of a computer-based solution

Age/sex Physician-based Present Illness Computer-based Present Illness Diagnostic Outcome
76/f Angina No acute disease Negative cardiac cath
39/m Exercise-induced angina Progressive chest pain for 6 months radiating to L. shoulder, L. elbow and palpitations with emotional upset not effort. Patient also had effort-induced tightness of the chest and shortness of breath. ?Atypical angina and reactive airway disease Negative cardiac cath; negative stress test.
50/f Atypical angina 6 months SOB and tightness of chest with exercise and strong odors. No acute changes. No diagnosis. No treatment.
49/m Pleuritic chest pain; fatigue; 2 days fever and chills: pneumonia. DOE progressive to dyspnea at rest at admission: heart failure Pericarditis
54/m Chest pain
? angina
No acute disease. Denied chest pain No work up.
Discharged in 1 day
85/f New onset recurrent angina DOE with daily chores. Old MI and denied recurrent chest pain. Negative cardiac cath
77/m Effort-induced chest pressure lasting 2 to 3 minutes and not relieved by NTG No acute disease Documented CAD by angiogram
76/m 2 years "angina" and dyspnea relieved by NTG No acute disease Documented CAD by angiogram
24/f Acute UTI No acute GU history Pyelonephritis