title: Clinical and economic benefits of using AUDICOR S3 detection for diagnosis and treatment of acute decompensated heart failure.
abstract: Because many of the signs and symptoms of acute decompensated heart failure (ADHF) are nonspecific (e.g., dyspnea), accurate diagnosis can be challenging. Highly specific indicators of ADHF can assist in early and accurate diagnosis, therefore providing a potential for better outcomes and cost efficiency. Demographic, clinical, laboratory, and electronically detected S3 data (Inovise Medical, Inc., Portland, OR) were collected in 340 emergency department patients with suspected ADHF. After hospital discharge, two blinded cardiologists determined whether ADHF was present. Total hospital charges were also recorded. The overall ED misdiagnosis rate was 14.0%, of which over 90% were a failure to recognize ADHF when it was present. The S3 was highly specific (94%) for ADHF and was valuable in combination with BNP values to improve the diagnostic accuracy in undifferentiated emergency department dyspenic patients. Misdiagnosed ADHF patients accrued over $2500 more in hospital charges than patients correctly diagnosed with ADHF, a 32% increase.
authors.affiliation: Department of Emergency Medicine, Cleveland Clinic, Cleveland, OH, USA.
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Alex
authors.initials: A
authors.lastname: Harrison
authors.forename: Donald
authors.initials: D
authors.lastname: Moffa
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003362:Cost-Benefit Analysis; D004562:Electrocardiography / Q000191:economics*; D004636:Emergency Service, Hospital; D005260:Female; D006326:Heart Auscultation / Q000295:instrumentation*; D006333:Heart Failure / Q000175:diagnosis* / Q000191:economics / Q000628:therapy*; D006347:Heart Sounds; D017721:Hospital Costs; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis; D010701:Phonocardiography / Q000295:instrumentation*; D011446:Prospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D055815:Young Adult
chemical_list: D020097:Natriuretic Peptide, Brain