cliot (version 1.0.0)

interchest_score: INTERCHEST Clinical Prediction Rule for Chest Pain in Primary Care

Description

Calculates the INTERCHEST score to assess the risk of unstable coronary artery disease (UCAD) in primary care patients presenting with chest pain. The score uses simple history and physical exam findings to stratify patients into low and high risk groups for urgent referral.

Usage

interchest_score(history_cad, age_risk, effort_pain, palpation_pain,
                 physician_suspicion, pressure_discomfort)

Value

A list containing:

INTERCHEST_Score

The calculated total score (Range -1 to 5).

Risk_Category

Classification (Very Low <= 1, Low 2, High >= 3).

Recommendation

Guidance on urgent vs. non-urgent follow-up.

Arguments

history_cad

Numeric (0 or 1). History of coronary artery disease (MI, PCI, CABG). (1 = Yes, +1 point).

age_risk

Numeric (0 or 1). Age threshold (Female >= 65, Male >= 55 years). (1 = Yes, +1 point).

effort_pain

Numeric (0 or 1). Chest pain related to effort. (1 = Yes, +1 point).

palpation_pain

Numeric (0 or 1). Pain reproducible by palpation. (1 = Yes, -1 point).

physician_suspicion

Numeric (0 or 1). Physician initially suspected a serious condition. (1 = Yes, +1 point).

pressure_discomfort

Numeric (0 or 1). Chest discomfort feels like "pressure" (rather than sharp/stabbing). (1 = Yes, +1 point).

References

Alghamdi A, Alghamdi R, Oliver G, et al. Enhanced triage for chest pain in primary care: a prediction rule for unstable coronary artery disease. Eur J Emerg Med. 2019;26(4):269-275. doi:10.1097/MEJ.0000000000000574

Examples

# Example 1: Very Low Risk
# Pain reproducible by palpation only
# Score = -1
interchest_score(0, 0, 0, 1, 0, 0)

# Example 2: High Risk
# Hx CAD (+1), Effort pain (+1), MD Suspicion (+1)
# Score = 3
interchest_score(1, 0, 1, 0, 1, 0)