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June 15, 1989Annals of Internal Medicine

Only 23% (261/1118) of AMI patients met eligibility criteria, with a positive predictive value of 81% (95% CI, 77% to 86%), indicating 1 to 2 false positives per 8 true positives treated.

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Why the study?

What is the true-positive and false-positive rate of clinical and ECG criteria for thrombolysis eligibility in emergency room patients with acute chest pain?

Population

7,734 emergency room patients with acute chest pain

Design

Cohort

Authors

TLThomas H. Lee

Discussion

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Overview

Strict criteria limit thrombolysis eligibility in AMI with notable false-positive risk; leaves open whether adjusted thresholds improve ER decision-making.

Structured PICO

What is the true-positive and false-positive rate of clinical and ECG criteria for thrombolysis eligibility in emergency room patients with acute chest pain?

P
Population
7,734 emergency room patients with acute chest pain
I
Intervention
Application of thrombolysis eligibility criteria (age ≤75 years, presentation within 4 hours of pain onset, ER ECG showing probable acute myocardial infarction)
O
Outcome
True-positive and false-positive rates of criteria for eligibility for thrombolysissurrogate

Only a small fraction of AMI patients meet strict thrombolysis eligibility criteria in the ER, and standard criteria yield a false-positive rate that could lead to inappropriate treatment if based on a single ECG.

Cite This Study

Thomas H. Lee (1989) studied this question.

synapsesocial.com/papers/6a83b6458dcee831255bcd18https://doi.org/10.7326/0003-4819-110-12-957
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