Randomised controlled trial of chest pain units is needed

doi:10.1136/bmj.321.7265.896

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Steve Goodacre (steveg@doctors.org.uk), research fellow,
Francis Morris, consultant in accident and emergency medicine,
Simon Capewell, professor of clinical epidemiology

Department of Accident and Emergency Medicine, Northern General Hospital, Sheffield S5 7AU
Department of Public Health, University of Liverpool, Liverpool L69 3GB

EDITOR—Collinson et al audited prognostically important myocardial damage in patients discharged from the emergency department—a large and important healthcare problem.1 The commentary by Kennedy touches on several key issues as well as the obvious limitations of such a study. As Kennedy says, further follow up data on the seven patients with raised concentrations of troponin would be useful.

Kennedy also touched on the issue of definitions. The seven missed Mayday patients …