{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:34:42Z","timestamp":1765827282041,"version":"build-2065373602"},"reference-count":40,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2014,12,5]]},"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Cardiologists face the difficult task of rapidly distinguishing cardiac-related chest pain from other conditions, and to thoroughly consider whether invasive diagnostic procedures or treatments are indicated. The use of cardiac risk-scoring instruments has been recommended in international cardiac guidelines. However, it is unknown to what degree cardiac risk scores and other clinical information influence cardiologists\u2019 decision-making. This paper describes the development of a binary choice experiment using realistic descriptions of clinical cases. The study aims to determine the importance cardiologists put on different types of clinical information, including cardiac risk scores, when deciding on the management of patients with suspected unstable angina or non-ST-elevation myocardial infarction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>Cardiologists were asked, in a nationwide survey, to weigh different clinical factors in decision-making regarding patient admission and treatment using realistic descriptions of patients in which specific characteristics are varied in a systematic way (eg, web-based clinical vignettes). These vignettes represent patients with suspected unstable angina or non-ST-elevation myocardial infarction. Associations between several clinical characteristics, with cardiologists\u2019 management decisions, will be analysed using generalised linear mixed models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study has received ethics approval and informed consent will be obtained from all participating cardiologists. The results of the study will provide insight into the relative importance of cardiac risk scores and other clinical information in cardiac decision-making. Further, the results indicate cardiologists\u2019 adherence to the European Society of Cardiology guideline recommendations. In addition, the detailed description of the method of vignette development applied in this study could assist other researchers or clinicians in creating future choice experiments.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2014-006441","type":"journal-article","created":{"date-parts":[[2015,4,8]],"date-time":"2015-04-08T22:22:39Z","timestamp":1428531759000},"page":"e006441","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical decision-making of cardiologists regarding admission and treatment of patients with suspected unstable angina or non-ST-elevation myocardial infarction: protocol of a clinical vignette study"],"prefix":"10.1136","volume":"5","author":[{"given":"Josien","family":"Engel","sequence":"first","affiliation":[{"name":"Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ineke","family":"van der Wulp","sequence":"additional","affiliation":[{"name":"Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith M","family":"Poldervaart","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary care, University Medical Center, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes B","family":"Reitsma","sequence":"additional","affiliation":[{"name":"Julius Centre for Health Sciences and Primary care, University Medical Center, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martine C","family":"de Bruijne","sequence":"additional","affiliation":[{"name":"Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cordula","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Public and Occupational Health, VU University Medical Center, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands"},{"name":"NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,4,8]]},"reference":[{"key":"2025101813562100000_5.4.e006441.1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.027599"},{"key":"2025101813562100000_5.4.e006441.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200004203421607"},{"key":"2025101813562100000_5.4.e006441.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)07492-2"},{"key":"2025101813562100000_5.4.e006441.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.05.019"},{"key":"2025101813562100000_5.4.e006441.5","doi-asserted-by":"publisher","DOI":"10.1007\/BF03086144"},{"key":"2025101813562100000_5.4.e006441.6","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.181940"},{"key":"2025101813562100000_5.4.e006441.7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr236"},{"key":"2025101813562100000_5.4.e006441.8","first-page":"1","article-title":"Guidelines for the management of acute coronary syndromes 2006","volume":"184","author":"Aroney","year":"2006","journal-title":"Med J Aust"},{"key":"2025101813562100000_5.4.e006441.9","unstructured":"National Institute for Health and Clinical Excellence. 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