Original Article

Real-World Evaluation of a Chest Pain Digital Triage Platform at the Point of Care

Authors: Jason Hourizadeh, DO, Roman Zeltser, MD, Amgad N. Makaryus, MD, Regina Druz, MD


This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Chou SC, Hong AS, Weiner SG et al. Impact of high-deductible health plans on emergency department patients with nonspecific chest pain and their subsequent care. Circulation 2021;144:336–349.
2. Gulati M, Levy P, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/ SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain. J Am Coll Cardiol 2021;78:e187–e285.
3. Venkatesh AK, Dai Y, Ross JS, et al. Variation in US hospital emergency department admission rates by clinical condition. Med Care 2015;53:237-244.
4. Terlizzi EP, Cha AE, Cohen RA. QuickStats: percentage of persons in families having problems paying medical bills in the past 12 months, by age group—National Health Interview Survey, 2011–2017. MMWR Morb Mortal Wkly Rep 2019;68:334.
5. Virani SS, Alonso A, Aparicio HJ, et al. Heart disease and stroke statistics—2021 update: a report from the American Heart Association. Circulation 2021;143: e254-e743.
6. Verzantvoort NCM, Teunis T, Verheij TJM, et al. Self-triage for acute primary care via a smartphone application: practical, safe and efficient? PLoS One 2018;13:e0199284.
7. Aboueid S, Meyer S, Wallace JR, et al. Young adults’ perspectives on the use of symptom checkers for self-triage and self-diagnosis: qualitative study. JMIR Public Health Surveill 2021;7:e22637.
8. Gilbert S, Mehl A, Baluch A, et al. How accurate are digital symptom assessment apps for suggesting conditions and urgency advice? A clinical vignettes comparison to GPs. BMJ Open 2020;10:e040269.
9. Garcia S, Albaghdadi MS, Meraj PM, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol 2020;75:2871-2872.
10. Lane BH, Mallow PJ, Hooker MB, et al. Trends in United States emergency department visits and associated charges from 2010 to 2016. Am J Emerg Med 2020;38:1576-1581.
11. Lange SJ, Ritchey MD, Goodman AB, et al. Potential indirect effects of the COVID-19 pandemic on use of emergency departments for acute life-threatening conditions—United States, January–May 2020. MMWR Morb Mortal Wkly Rep 2020;69:795-800.
12. Mafham MM, Spata E, Goldacre R, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet 2020;396:381-389.
13. Metzler B, Siostrzonek P, Binder RK, et al. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020;41:1852-1853.
14. De Filippo O, D’Ascenzo F, Angelini F, et al. Reduced rate of hospital admissions for ACS during Covid-19 outbreak in northern Italy. N Engl J Med 2020;383:88-89.
15. De Rosa S, Spaccarotella C, Basso C, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 2020;41: 2083-2088.
16. Rodríguez-Leor O, Álvarez BC, Ojeda S, et al. Impacto de la pandemia de COVID-19 sobre la actividad asistencial en cardiología intervencionista en España. Intervent Cardiol 2020;2:82-89.
17. Solomon MD, McNulty EJ, Rana JS, et al. The Covid-19 pandemic and the incidence of acute myocardial infarction. N Engl J Med 2020;383: 691-693.
18. Baldi E, Sechi GM, Mare C, et al. COVID-19 kills at home: the close relationship between the epidemic and the increase of out-of-hospital cardiac arrests. Eur Heart J 2020;41:3045-3054.
19. Mountantonakis SE, Saleh M, Coleman K, et al. Out-of-hospital cardiac arrest and acute coronary syndrome hospitalizations during the COVID-19 surge. J Am Coll Cardiol 2020;76:1271-1273.
20. Semigran HL, Linder JA, Gidengil C, et al. Evaluation of symptom checkers for self diagnosis and triage: audit study. BMJ 2015;351: h3480.
21. Wallace W, Chan C, Chidambaram S, et al. The diagnostic and triage accuracy of digital and online symptom checker tools: a systematic review. NPJ Digit Med 2022;5:118.
22. Barzi A, Sadeghi S, King BR. Self-administered decision support tool for triage: results of a retrospective study. Stud Health Technol Inform 2002; 85:45-51.
23. Sadeghi S, Barzi A, Sadeghi N, et al. A Bayesian model for triage decision support. Int J Med Inform 2006;75:403-411.
24. Graber MA, VanScoy D. How well does decision support software perform in the emergency department? Emerg Med J 2003;20:426-428.
25. Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction (2018). J Am Coll Cardiol 2018;72:2231-2264.