Evaluation of Patients With Chest Pain and Normal Coronary Angiograms
Bibliographic record
Abstract
ver 1 million coronary angiograms are performed in North America annually, and a significant number are interpreted as normal.In the Coronary Artery Surgery Study Registry of the 1970s, normal angiograms were found in 19% of patients, 1 and the prevalence may not have changed in the current era of more sophisticated noninvasive testing.A recent study found that 19% of patients had no arteriographic evidence of disease. 2 For women selected for angiography, a normal result is found 3 times more frequently than for men. 1,2Further elucidation of the diagnosis in a patient population of this size is of obvious importance.However, correctly investigating and managing the treatment for such patients can be challenging.On the one hand, a potentially serious, yet manageable condition must not be overlooked.On the other hand, excessive anxiety over a problem that may not exist or may not be serious must not be created.Therefore, the finding of a normal angiogram in a patient with chronic chest pain in whom coronary disease was suspected prior to the procedure must lead to a thorough investigation (Figure 1).The pathophysiologic features, investigation, and treatment of chest pain in these patients are the subject of this review.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".