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      <title>Mozgásszervi eredetű mellkasi fájdalmat felismerő klinikai predikciós modell fejlesztése</title>
      <subTitle>Prospektív pilotvizsgálati elképzelés</subTitle>
      <altTitles>Development of a novel clinical prediction model for musculoskeletal chest pain in the emergency department. Prospective pilot study idea</altTitles>
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      <abstractText>Bevezetés: A sürgősségi osztályokra kis kockázatú mellkasi fájdalommal érkező betegek differenciáldiagnosztikája világszerte jelentős klinikai és egészség-gazdaságtani kihívást jelent. Bár a legtöbb esetben nem cardiopulmonalis eredetű kórképek állnak a tünetek hátterében, az ellátás elsődleges célja az életet veszélyeztető állapotok – elsősorban az akut coronariaszindróma és a tüdőembolia – gyors és biztonságos felismerése/kizárása. A túlzott diagnosztikus vizsgálatok ugyanakkor növelik az ellátási költségeket, és fokozzák az osztályok leterheltségét. Korábban publikált megfigyeléseink szerint a pleuriticus és/vagy mozgásszervi jellegű mellkasi fájdalommal jelentkező felnőtt betegek körében gyakrabban előfordul korábban fel nem ismert gerincaszimmetria, amely a bordaízületek (costosternalis, ritkábban costovertebralis) subluxatiójára hajlamosíthat. Célkitűzés: A tervezett multicentrikus, prospektív vizsgálat célja a gerincaszimmetria előfordulásának és klinikai jelentőségének meghatározása ambuláns, kis kockázatú, mellkasi fájdalommal jelentkező felnőttek körében, valamint egy új, mozgásszervi eredetű mellkasi fájdalmat azonosító klinikai predikciós modell fejlesztése. Módszerek: A vizsgálat elsődleges kimeneti változói a tüdőembolia és a major cardialis események (nem ST-elevációs myocardialis infarktus, instabil angina). Korábban validált számítás alapján 2500 beteg bevonása biztosítja a megfelelő statisztikai erőt a II. típusú hiba elkerülésére. A betegek 30, 90 és 365 napos utánkövetése során regisztráljuk a szövődményeket, az ismételt megjelenéseket, a major cardialis eseményeket és a mortalitást. Várható eredmények: Feltételezésünk szerint a gerincaszimmetria jelenléte oki összefüggést mutat az akut, mozgásszervi jellegű mellkasi fájdalommal, amely ebben a betegcsoportban nem jár együtt emelkedett mortalitási kockázattal. Egy újonnan kidolgozott predikciós eszköz feltehetően lehetővé teheti a mozgásszervi eredetű mellkasi fájdalom korai felismerését és biztonságos elkülönítését a cardiopulmonalis kórképektől. Következtetés: A vizsgálat eredményei hozzájárulhatnak a sürgősségi betegellátás diagnosztikus protokolljának finomításához, a szükségtelen vizsgálatok számának csökkentéséhez, valamint a költséghatékonyság és a betegelégedettség javításához. Orv Hetil. 2026; 167(5): 180–187. | Introduction: The diagnostic work-up of patients presenting to the emergency department with chest pain remains a
major clinical and health-economic challenge worldwide. Although most cases are caused by benign, non-cardiopul-
monary conditions, the primary goal of emergency care is the timeous, but safe exclusion of life-threatening disorders
– mainly acute coronary syndrome and pulmonary embolism. Excessive diagnostic testing increases both healthcare
costs and emergency department overcrowding. Preliminary observations suggest that previously unrecognized spi-
nal asymmetry or scoliosis is more prevalent among ambulatory adults presenting with pleuritic or musculoskeletal-
type chest pain, potentially predisposing to costosternal or costovertebral subluxation as a mechanical pain generator.
Objective: The planned prospective, multicenter study aims to assess the prevalence and clinical significance of spinal
asymmetry among ambulatory, low-risk adults presenting with chest pain, and to develop/validate a novel musculo-
skeletal chest pain clinical prediction model.
Methods: Primary outcome variables include pulmonary embolism and major cardiac events (non-ST-elevation myo-
cardial infarction, unstable angina). Based on power calculations by Peduzzi et al. (1996), a total of 2,500 patients
will provide adequate statistical power to avoid Type II error. Patients will be followed up at 30, 90, and 365 days for
complications, recurrent visits, major adverse cardiac events, and mortality. Data will be analyzed using bootstrapping
techniques for internal validation of the derived score.
Expected results: We hypothesize that spinal asymmetry independently correlates with acute musculoskeletal chest
pain but does not confer an increased risk of short- or long-term mortality. The newly developed musculoskeletal
chest pain clinical prediction model may facilitate early recognition and safe management of musculoskeletal chest
pain in the emergency department setting.
Conclusion: This study is expected to refine diagnostic algorithms for low-risk chest pain, reduce unnecessary inves-
tigations, improve cost-effectiveness, and enhance patient satisfaction.</abstractText>
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      <label>Ádám Kornél et al. Mozgásszervi eredetű mellkasi fájdalmat felismerő klinikai predikciós modell fejlesztése: Prospektív pilotvizsgálati elképzelés. (2026) ORVOSI HETILAP 0030-6002 1788-6120 167 5 180-187</label><template>&lt;div class=&quot;JournalArticle Publication short-list&quot;&gt; &lt;div class=&quot;authors&quot;&gt; &lt;span class=&quot;author-name&quot; mtid=&quot;10097435&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10097435&quot; target=&quot;_blank&quot;&gt;Ádám, Kornél&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; mtid=&quot;10024884&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10024884&quot; target=&quot;_blank&quot;&gt;Varga, Csaba&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; mtid=&quot;10061477&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10061477&quot; target=&quot;_blank&quot;&gt;Fenyves, Bánk G.&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; &gt; Hegyi, Krisztina &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; &gt; Kostyál, László &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; &gt; Finta, Ervin &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; mtid=&quot;10026634&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10026634&quot; target=&quot;_blank&quot;&gt;Kanizsai, Péter&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; mtid=&quot;10002883&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10002883&quot; target=&quot;_blank&quot;&gt;Lelovics, Zsuzsanna&lt;sup&gt;**&lt;/sup&gt; ✉&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; ; &lt;span class=&quot;author-name&quot; mtid=&quot;10073833&quot;&gt; &lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10073833&quot; target=&quot;_blank&quot;&gt;Xantus, Gábor&lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-type&quot;&gt; &lt;/span&gt; &lt;/div &gt;&lt;div class=&quot;title&quot;&gt;&lt;a href=&quot;/gui2/?mode=browse&amp;params=publication;36914162&quot; mtid=&quot;36914162&quot; target=&quot;_blank&quot;&gt;Mozgásszervi eredetű mellkasi fájdalmat felismerő klinikai predikciós modell fejlesztése&lt;span class=&quot;subTitle&quot;&gt;: Prospektív pilotvizsgálati elképzelés&lt;/span&gt;&lt;/a&gt;&lt;/div&gt; &lt;div class=&quot;pub-info&quot;&gt; &lt;span class=&quot;journal-title&quot;&gt;ORVOSI HETILAP&lt;/span&gt; &lt;span class=&quot;journal-volume&quot;&gt;167&lt;/span&gt; : &lt;span class=&quot;journal-issue&quot;&gt;5&lt;/span&gt; &lt;span class=&quot;page&quot;&gt; pp. 180-187. , 8 p. &lt;/span&gt; &lt;span class=&quot;year&quot;&gt;(2026)&lt;/span&gt; &lt;/div&gt; &lt;div class=&quot;pub-end&quot;&gt;&lt;div class=&quot;identifier-list&quot;&gt; &lt;span class=&quot;identifiers&quot;&gt; &lt;span class=&quot;id identifier oa_GOLD&quot; title=&quot; Gold &quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;10.1556/650.2026.33484&quot; target=&quot;_blank&quot; href=&quot;https://doi.org/10.1556/650.2026.33484&quot;&gt; DOI &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;id identifier oa_GREEN&quot; title=&quot; Green &quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;233206&quot; target=&quot;_blank&quot; href=&quot;http://real.mtak.hu/233206&quot;&gt; REAL &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;id identifier oa_none&quot; title=&quot;none&quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;001677121900001&quot; target=&quot;_blank&quot; href=&quot;https://www.webofscience.com/wos/woscc/full-record/001677121900001&quot;&gt; WoS &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;id identifier oa_none&quot; title=&quot;none&quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;105029181349&quot; target=&quot;_blank&quot; href=&quot;http://www.scopus.com/record/display.url?origin=inward&amp;eid=2-s2.0-105029181349&quot;&gt; Scopus &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;id identifier oa_none&quot; title=&quot;none&quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;41621021&quot; target=&quot;_blank&quot; href=&quot;http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;list_uids=41621021&amp;dopt=Abstract&quot;&gt; PubMed &lt;/a&gt; &lt;/span&gt; &lt;/span&gt; &lt;/div&gt; &lt;div class=&quot;short-pub-prop-list&quot;&gt; &lt;span class=&quot;short-pub-mtid&quot;&gt; Közlemény:36914162 &lt;/span&gt; &lt;span class=&quot;status-holder&quot;&gt;&lt;span class=&quot;status-data status-VALIDATED&quot;&gt; Egyeztetett &lt;/span&gt;&lt;/span&gt; &lt;span class=&quot;pub-core&quot;&gt;Forrás &lt;/span&gt; &lt;span class=&quot;pub-type&quot;&gt;Folyóiratcikk (Szakcikk ) &lt;/span&gt; &lt;!-- &amp;&amp; !record.category.scientific --&gt; &lt;span class=&quot;pub-category&quot;&gt;Tudományos&lt;/span&gt; &lt;/div&gt; &lt;/div&gt; &lt;/div&gt;</template><template2>&lt;div class=&quot;JournalArticle Publication long-list&quot;&gt; &lt;div class=&quot;authors&quot;&gt; &lt;img title=&quot;Forrásközlemény&quot; style=&quot;float: left&quot; src=&quot;/frontend/resources/grid/publication-core-icon.png&quot;&gt; &lt;div class=&quot;autype autype0&quot;&gt; &lt;span class=&quot;author-name&quot; mtid=&quot;10097435&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10097435&quot; target=&quot;_blank&quot;&gt;Ádám Kornél (&lt;span class=&quot;authorship-author-name&quot;&gt;Ádám Kornél&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; sürgősségi ellátás&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Klinikum&quot;&gt;K&lt;/span&gt;/Sürgősségi Orvostani Klinika&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10024884&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10024884&quot; target=&quot;_blank&quot;&gt;Varga Csaba (&lt;span class=&quot;authorship-author-name&quot;&gt;Varga Csaba&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Sürgősségi ellátás&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Klinikum&quot;&gt;K&lt;/span&gt;/Sürgősségi Orvostani Klinika; &lt;span title=&quot;Pécsi Tudományegyetem&quot;&gt;PTE&lt;/span&gt;/&lt;span title=&quot;Egészségtudományi Kar&quot;&gt;ETK&lt;/span&gt;/&lt;span title=&quot;Sürgősségi, Egészségpedagógiai és Ápolástudományi Intézet&quot;&gt;SEÁI&lt;/span&gt;/Oxiológiai, Sürgősségi Ellátási Tanszék&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10061477&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10061477&quot; target=&quot;_blank&quot;&gt;Fenyves Bánk G. (&lt;span class=&quot;authorship-author-name&quot;&gt;Fenyves Bánk&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Biológia, Oxyológia és Sürgősségi orvostan&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Klinikum&quot;&gt;K&lt;/span&gt;/Sürgősségi Orvostani Klinika&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; &gt;Hegyi Krisztina &lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; &gt;Kostyál László &lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; &gt;Finta Ervin &lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10026634&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10026634&quot; target=&quot;_blank&quot;&gt;Kanizsai Péter (&lt;span class=&quot;authorship-author-name&quot;&gt;Kanizsai Péter László&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Aneszteziológia-Oxiológia&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Pécsi Tudományegyetem&quot;&gt;PTE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;ÁOK&lt;/span&gt;/Sürgősségi Klinika&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10002883&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10002883&quot; target=&quot;_blank&quot;&gt;Lelovics Zsuzsanna&lt;sup&gt;**&lt;/sup&gt; ✉ (&lt;span class=&quot;authorship-author-name&quot;&gt;Lelovics Zsuzsanna&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Táplálkozáskutató&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Pécsi Tudományegyetem&quot;&gt;PTE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;ÁOK&lt;/span&gt;/Orvosi Népegészségtani Intézet&lt;/span&gt; ;&amp;nbsp;&amp;nbsp;&amp;nbsp; &lt;span class=&quot;author-name&quot; mtid=&quot;10073833&quot;&gt;&lt;a href=&quot;/gui2/?type=authors&amp;mode=browse&amp;sel=10073833&quot; target=&quot;_blank&quot;&gt;Xantus Gábor (&lt;span class=&quot;authorship-author-name&quot;&gt;Xantus Gábor&lt;/span&gt; &lt;span class=&quot;authorAux-mtmt&quot;&gt; Critical Care&lt;/span&gt;) &lt;/a&gt; &lt;/span&gt; &lt;span class=&quot;author-affil&quot;&gt;&lt;span title=&quot;Semmelweis Egyetem&quot;&gt;SE&lt;/span&gt;/&lt;span title=&quot;Általános Orvostudományi Kar&quot;&gt;AOK&lt;/span&gt;/&lt;span title=&quot;Klinikum&quot;&gt;K&lt;/span&gt;/Családorvosi Tanszék&lt;/span&gt; &lt;/div&gt; &lt;/div&gt; &lt;div class=&quot;title&quot;&gt;&lt;a href=&quot;/gui2/?mode=browse&amp;params=publication;36914162&quot; target=&quot;_blank&quot;&gt;Mozgásszervi eredetű mellkasi fájdalmat felismerő klinikai predikciós modell fejlesztése : Prospektív pilotvizsgálati elképzelés.&lt;/a&gt;&lt;/div&gt; &lt;div&gt; &lt;span class=&quot;journal-title&quot;&gt;ORVOSI HETILAP&lt;/span&gt; &lt;span class=&quot;journal-issn&quot;&gt;(&lt;a target=&quot;_blank&quot; href=&quot;https://portal.issn.org/resource/ISSN/0030-6002&quot;&gt;0030-6002&lt;/a&gt; &lt;a target=&quot;_blank&quot; href=&quot;https://portal.issn.org/resource/ISSN/1788-6120&quot;&gt;1788-6120&lt;/a&gt;)&lt;/span&gt;: &lt;span class=&quot;journal-volume&quot;&gt;167&lt;/span&gt; &lt;span class=&quot;journal-issue&quot;&gt;5&lt;/span&gt; &lt;span class=&quot;page&quot;&gt; pp 180-187 &lt;/span&gt; &lt;span class=&quot;year&quot;&gt;(2026)&lt;/span&gt; &lt;/div&gt; &lt;div class=&quot;pub-footer&quot;&gt;  &lt;span class=&quot;language&quot; xmlns=&quot;http://www.w3.org/1999/html&quot;&gt;Nyelv: Magyar | &lt;/span&gt; &lt;span class=&quot;identifiers&quot;&gt; &lt;span class=&quot;id identifier oa_GOLD&quot; title=&quot; Gold &quot;&gt; &lt;a style=&quot;color:blue&quot; title=&quot;10.1556/650.2026.33484&quot; target=&quot;_blank&quot; href=&quot;https://doi.org/10.1556/650.2026.33484&quot;&gt; DOI &lt;/a&gt; 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