est applicability and potential to benefit patients, hospitals, health care organizations, and health care plans throughout the country. The greatest challenge is then to apply these principles and this information to the ongoing care of patients.
For many years, it has been recognized that there are wide and often unexplainable variations in the provision of medical care by physicians. Practice guidelines and expert systems that are based on outcomes research may enable attainment of the goal of providing patients with services that are most likely to improve their outcomes. In a recent health services research study performed at Cedars-Sinai Medical Center (CSMC), we developed guidelines to improve the quality and efficiency of medical care for patients hospitalized with chest pain.[1] Chest pain was chosen because this symptom may signify the presence of dis
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