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Adults with chest pain who are admitted to the hospital from the emergency department after two negative troponin tests and non-concerning vital signs, among other indicators, rarely have adverse cardiac events, according to a  published online today by JAMA Internal Medicine. The study reviewed data for more than 11,000 such patients admitted to three community teaching hospitals for inpatient or observation status between 2008 and 2013, and found only 0.06% of the patients experienced a clinically relevant adverse cardiac event. The authors said the findings “suggest that further evaluation may be best performed in the outpatient rather than the inpatient setting, and that this information should be integrated into shared decision-making discussions regarding potential admission.”