Key result
ST elevation on electrocardiogram was the most effective feature for determining myocardial infarction with a positive likelihood ratio of 13.1, whereas clinical features in isolation were not useful.
Why the study?
Do clinical features, electrocardiography, and rapid access chest pain clinics improve diagnosis in patients with acute and chronic chest pain?
Population
Patients with acute chest pain with data on the diagnostic value of clinical features or an…
Comparison
Clinical features, resting and exercise… vs Models of care based around open access exercise…
Design
Systematic_review
Authors
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Prioritize ECG over symptoms alone for MI diagnosis; confirms limited utility of clinical features in chest pain evaluation.
Systematic Review
Do clinical features, electrocardiography, and rapid access chest pain clinics improve diagnosis in patients with acute and chronic chest pain?
Effect estimate: LR+ 13.1
Clinical features and ECG have specific diagnostic utility for chest pain, while rapid access chest pain clinics and point-of-care troponin testing improve diagnostic timeliness and cost-effectiveness.
Mant et al. (2005) conducted a systematic review in Acute and chronic chest pain, suspected acute coronary syndrome (ACS), acute myocardial infarction (MI), and exertional angina. Clinical features, resting and exercise electrocardiography (ECG), and rapid access chest pain clinics (RACPCs) was evaluated on Determination of myocardial infarction using ST elevation on ECG (LR+ 13.1). ST elevation on electrocardiogram was the most effective feature for determining myocardial infarction with a positive likelihood ratio of 13.1, whereas clinical features in isolation were not useful.
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