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

In cliot: Clinical Indices and Outcomes Tools

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)

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).

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.

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)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.