Key result
The modified TIMI risk score outperformed the original score for overall diagnostic accuracy of 30-day cardiac events (AUC 0.83 vs 0.79; absolute difference 0.037; 95% CI 0.004-0.071; P=0.030).
Why the study?
Does a modified TIMI risk score improve diagnostic accuracy and risk stratification compared to the original TIMI risk score in emergency department patients with chest pain?
Population
1,017 emergency department patients over 24 years of age with a primary complaint of chest pain and possible…
Comparison
Modified Thrombolysis In Myocardial Infarction… vs Original Thrombolysis In Myocardial Infarction…
Design
Cohort
Follow-up
30 days
Authors
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May improve ED chest pain stratification accuracy; leaves open safe early discharge without additional testing.
Cohort (n=1,017)
No
Does a modified TIMI risk score improve diagnostic accuracy and risk stratification compared to the original TIMI risk score in emergency department patients with chest pain?
Mean Difference: 0.037 (95% CI 0.004–0.071)
Absolute Event Rate: 0.83% vs 0.79%
p-value: p=0.030
While the modified TIMI risk score improves overall diagnostic accuracy compared to the original score, neither score is sufficiently sensitive or specific to be used as the sole tool for determining safe early discharge in ED patients with chest pain.
Hess et al. (2010) conducted a cohort in chest pain and possible acute coronary syndrome (n=1,017). Modified TIMI risk score vs. Original TIMI risk score was evaluated on acute myocardial infarction (AMI), revascularization, or death within 30 days (absolute difference 0.037, 95% CI 0.004 to 0.071, p=0.030). The modified TIMI risk score outperformed the original score for overall diagnostic accuracy of 30-day cardiac events (AUC 0.83 vs 0.79; absolute difference 0.037; 95% CI 0.004-0.071; P=0.030).
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