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  1. Kevin Mackway-Jones, Editor

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Back to the future

Emergency Physicians are diagnosticians all of the time and (short-term) therapists some of the time. It is interesting to consider how, then, information about longer-term outcomes can be of value to them. Two papers in this month's journal explore how information about prognosis that is available (or potentially available) in the Emergency Department can be of utilised. Thomas Guidez and colleagues, from Lille, France, (see page 274) consider the role of B-type natriuretic peptide as an adjunct to the GRACE score in predicting acute myocardial infarction or death in patients with acute coronary syndrome. They show that the GRACE score together with BNP is better than the GRACE score alone at predicting the outcomes at 6 months. Perhaps more importantly from an Emergency Physicians' viewpoint, the addition of BNP refines the allocation of individual patients to risk groups at presentation, and may therefore alter initial treatment decisions. In a separate paper Hermans and coworkers, from Maastricht, the Netherlands, compare the performance of the Mortality in …

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