Ep 128 - Can we use diagnostic probability to guide treatment thresholds in ACS with Charlie Reynard and Rick Body

In this episode of the St. Emlyn's podcast, Rick Body and Charlie Reynard discuss an influential research project conducted by Dr. Reynard during his academic foundation program. The paper, titled 'Optimizing Antiplatelet Utilization in the Acute Care Setting,' explores decision-making under clinical uncertainty, specifically in emergency medicine for suspected acute coronary syndromes (ACS). Through systematic reviews and decision tree modeling, the research evaluates the benefits and risks of various antiplatelet therapies, such as Ticagrelor and aspirin versus Clopidogrel and aspirin. The findings reveal that Ticagrelor and aspirin are often more beneficial for patients with a greater than 8% probability of ACS, while Clopidogrel holds little to no place in current practice. The discussion opened up new questions about dynamic risk prediction and the importance of modeling to inform clinical decisions. 00:00 Introduction to the Podcast 00:26 Charlie's Research Background 00:52 Overview of the Research Paper 01:17 Decision Making Under Uncertainty 03:05 Systematic Reviews and Data Collection 03:46 Building the Decision Tree Model 04:48 Results and Key Findings 08:07 Implications for Clinical Practice 09:19 Future Directions and Conclusion