A prospective cohort study to refine and validate thePanic Screening Scorefor identifying panic attacks associated with unexplained chest pain in the emergency department

Abstract

IntroductionPanic-like anxiety (panic attacks with or without panic disorder), a highly treatable condition, is the most prevalent condition associated with unexplained chest pain in the emergency department. Panic-like anxiety may be responsible for a significant portion of the negative consequences of unexplained chest pain, such as functional limitations and chronicity. However, more than 92% of panic-like anxiety cases remain undiagnosed at the time of discharge from the emergency department. The 4-item Panic Screening Score (PSS) questionnaire was derived in order to increase the identification of panic-like anxiety in emergency department patients with unexplained chest pain.Methods and analysisThe goals of this prospective cohort study were to (1) refine the PSS; (2) validate the revised version of the PSS; (3) measure the reliability of the revised version of the PSS and (4) assess the acceptability of the instrument among emergency physicians. Eligible and consenting patients will be administered the PSS in a large emergency department. Patients will be contacted by phone for administration of the criterion standard for panic attacks as well as by a standardised interview to collect information for other predictors of panic attacks. Multivariate analysis will be used to refine the PSS. The new version will be prospectively validated in an independent sample and inter-rater agreement will be assessed in 10% of cases. The screening instrument acceptability will be assessed with the Ottawa Acceptability of Decision Rules Instrument.Ethics and disseminationThis study protocol has been reviewed and approved by the Alphonse-Desjardins research ethics committee. The results of the study will be presented in scientific conferences and published in peer-reviewed scientific journals. Further dissemination via workshops and a dedicated website is planned.

The Revised-Panic Screening Score for emergency department patients with noncardiac chest pain.

“…Next, patients who agreed to be contacted for research purposes were contacted for a telephone interview. Due to logistical difficulties, consenting patients were interviewed by telephone rather than on site, as originally planned (Foldes-Busque et al, 2013). The interview began with the assessment of the candidate predictors and the PSS, followed by the panic-like anxiety diagnostic interview.…”

“…This prospective multicenter study was approved by the Research Ethics Committee at the Centre Intégré de Santé et de Services Sociaux de Chaudière-Appalaches. The detailed research protocol has been published elsewhere (Foldes-Busque et al, 2013). Modifications to the protocol made over the course of the 3-month run-in period are highlighted below.…”

Hyperventilation syndrome: diagnosis and reassurance

“…The literature shows that the utilisation of HVS screening tools is associated with low staff adherence rates and a reluctance of patients to participate, which highlights the need for a more personalised approach to HVS diagnosis and the benefit of GP involvement (Bokma et al 2015). Nevertheless, a newly developed screening tool known as the Panic Screening Score, which has been specifically designed to detect HVS in the A&E setting in Canada, is currently being refined and validated in a prospective cohort study (Foldes-Busque et al 2013).…”

Crise De Pânico: Abordagem No Pronto-Socorro

“…", "Quando fica nervoso tem a sensação de que vai sufocar até a morte?" (FOLDES-BUSQUE et al, 2013). Sabe-se que o medo focado na ideia de que algo acontecerá com o coração contribui para o surgimento da dor torácica não cardíaca através da sua forte relação com sintomas de TP e Transtorno de Ansiedade Generalizada (FOLDES-BUSQUE et al, 2016) Remanejar o paciente para um ambiente mais calmo e tranquilizá-lo em relação ao caráter rápido e autolimitado dos sintomas do AP, muitas vezes já é o suficiente para amenizar o quadro, vide Figura 1 (ABRÃO, 2004).…”