Editor,—Goodacre concluded in the January 2000 issue of the journal “there is no strong evidence that chest pain observation units (CPOU) will improve outcomes” and further evidence is necessary to determine whether this approach can be applied in the United Kingdom.¹ He did not reach this conclusion from the cost studies that he listed in table 2. These savings were present in all nine studies reviewed and ranged from $1873 per patient to $567 per patient. He reached this conclusion from examination …