How emergency doctors’ decisions about chest pain affect testing and outcomes
Official title: Variation in Chest Pain Admission Among Emergency Department Clinicians and Its Impact on Subsequent Testing and Patient Outcomes
Funded at University of California, San Francisco · NIH-11371961 · Data updated 2026-11-12
A study using Medicare data will see if doctors who tend to admit chest-pain patients to the hospital lead to more tests and different outcomes for those patients.
Quick facts
| Grant type | R03 grant |
|---|---|
| Study type | NIH-funded research |
| Funding institution | University of California, San Francisco NIH-funded |
| Lab location | 1 site (San Francisco, United States) |
| Project start | August 14, 2026 |
| Project end | May 31, 2028 |
| Funding year | 2026 |
| Award (this year) | $246,000 |
| NIH project number | 1R03HL180982-01A1 |
| Project ID | NIH-11371961 on NIH RePORTER |
Who could benefit from this research
✓Could help
Adults presenting to the emergency department with chest pain but no evidence of acute coronary syndrome.
✕Less likely to help
Patients whose chest pain is clearly high-risk or whose care requires immediate invasive evaluation may not benefit from altered admission practices.
What this research studies
This project looks at chest pain visits to the emergency department and asks whether the admitting style of individual clinicians changes what tests patients receive and how they do after leaving the ED. By examining a large national sample from 2013–2020, researchers will compare high-admitting versus low-admitting clinicians within the same ED to minimize bias. The study will track downstream testing, procedures, and outcomes to understand potential downstream effects of admission decisions. The goal is to identify practice patterns that may contribute to unnecessary testing and costs while ensuring patient safety.
Why it matters
Potential benefit: If successful, findings could guide more consistent, evidence-based admission decisions to reduce unnecessary testing and costs while maintaining good patient outcomes.
How similar studies have gone: Prior work has shown variation in physician practice affects resource use; this study builds on that with a large national dataset and quasi-random patient assignment.
Where this research is happening
-
University of California, San Francisco
San Francisco, United States Active
Researchers
- Principal investigator: Chou, Shih-Chuan — University of California, San Francisco
- Study coordinator: Chou, Shih-Chuan
Related research
Other NIH-funded projects on the same topics.
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ECG-BASED smart tools to quickly classify chest pain in emergency care
A patient-focused project to use advanced ECG analysis and machine learning to quickly identify heart problems in people with chest pain when they arrive at the ER.
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Using ECGs to find hidden heart attacks in people with chest pain
This project is creating smart ECG tools to quickly spot heart attacks that don't show the classic ST-elevation in people who come to the emergency room with chest pain.
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MACE-Alert: AI tools to help triage chest pain in the emergency department
An AI-powered system and a patient-facing chat tool aim to improve how emergency teams evaluate and triage people with chest pain.
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Electrocardiographic warning system to speed up chest-pain care (ECG-SMART 2)
A research project is testing new ECG-based computer tools to quickly and safely identify patients with potentially serious chest pain in emergency departments.
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Evaluating a new approach for managing chest pain patients in outpatient settings
This study is testing a new way to help people with chest pain who aren't at high risk by letting them go home from the emergency room instead of staying in the hospital, and then checking in with them within three days to make sure they're doing okay and to manage any heart health concerns.
-
Improving ECG methods to quickly identify heart issues in chest pain patients
This study is working on a new tool to help doctors quickly and accurately check patients with chest pain in the emergency room, using advanced technology to spot heart issues that might be missed by regular tests, so they can provide faster and better care for you.
About this research
- This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
- Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
- For full project details, budget, and progress reports, visit the official NIH RePORTER page.