Diamond and Forrester Decision Rule for Likelihood of Cardiac Chest Pain
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Factors:
<-- Substernal chest pain
<-- Exertional chest pain
<-- Chest pain relieved with rest
Demographics:
<-- Age (years)
<-- Gender
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Result --> classificationscore1=(Q1)+(Q2)+(Q3);score1>2?'Typical angina':score1>1?'Atypical angina':score1>0?'Non-anginal chest pain':'No criteria present'
Interpretation --> riskscore2=(Q1)+(Q2)+(Q3)+(Q4)+(Q5);score2>142?'94% likelihood (high)':score2>141?'72% likelihood (intermediate)':score2>140?'27% likelihood (intermediate)':score2>139?'Risk is low to very low':score2>132?'93% likelihood (high)':score2>131?'65% likelihood (intermediate)':score2>130?'20% likelihood (intermediate)':score2>129?'Risk is low to very low':score2>122?'87% likelihood (high)':score2>121?'51% likelihood (intermediate)':score2>120?'13% likelihood (intermediate)':score2>119?'Risk is low to very low':score2>112?'76% likelihood (intermediate)':score2>111?'34% likelihood (intermediate)':score2>110?'4% likelihood (low)':score2>109?'Risk is low to very low':score2>42?'86% likelihood (high)':score2>41?'51% likelihood (intermediate)':score2>40?'14% likelihood (intermediate)':score2>39?'Risk is low to very low':score2>32?'73% likelihood (intermediate)':score2>31?'31% likelihood (intermediate)':score2>30?'7% likelihood (low)':score2>29?'Risk is low to very low':score2>22?'55% likelihood (intermediate)':score2>21?'22% likelihood (low)':score2>20?'3% likelihood (low)':score2>19?'Risk is low to very low':score2>12?'26% likelihood (intermediate)':score2>11?'12% likelihood (low)':score2>10?'2% likelihood (low)':'Risk is low to very low'
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references:
#1 Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979 Jun 14;300(24):1350-8.
#2 FP Notebook page

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