Table 3 Diagnostic performance of physician assessments in percent (95% CI) for ACS within 30 days
Sensitivity | Specificity | LR+ | LR- | |
|---|---|---|---|---|
Chest pain history | ||||
Typical of ACS | 86 (80–91) | 80 (77–82) | 4.3 (3.8-5.0) | 0.2 (0.1-0.3) |
Typical of AMI± | 47 (38–57) | 90 (88–92) | 4.9 (3.7-6.5) | 0.6 (0.5-0.7) |
Typical of UA≠ | 73 (60–84) | 87 (85–89) | 5.6 (4.5-7.1) | 0.3 (0.2-0.5) |
Nonspecific for ACS | 13 (8–19) | 61 (58–64) | 0.3 (0.2-0.5) | 1.4 (1.3-1.5) |
Not suspicious of ACS | 1 (0–4) | 59 (56–62) | 0.02 (0.00-0.12) | 1.7 (1.6-1.8) |
ECG | ||||
ST-elevation | 11 (7–17) | 99 (99–100) | 15.7 (6.6-37.6) | 0.9 (0.8-0.9) |
ST-depression | 20 (14–27) | 98 (97–99) | 11.7 (6.6-20.8) | 0.8 (0.8-0.9) |
T-wave inversion | 8 (5–14) | 98 (97–98) | 3.6 (1.8-7.1) | 0.9 (0.9-1.0) |
Non-Ischemic* | 59 (51–67) | 5 (4–6) | 0.6 (0.5-0.7) | 7.6 (5.5-10.6) |
TnT | ||||
Positive initial TnT | 42 (34–50) | 98 (97–99) | (15.0-41.5) | 0.7 (0.5- 0.7) |
Overall suspicion of ACS | ||||
Obvious ACS | 12 (7–18) | 100 (99–100) | 29 (10–86) | 0.9 (0.8-0.9) |
Strong suspicion | 71 (63–77) | 85 (83–87) | 4.8 (4.0-5.8) | 0.4 (0.3-0.4) |
Low suspicion | 18 (12–25) | 59 (56–62) | 0.4 (0.3-0.6) | 1.4 (1.3-1.5) |
No suspicion | 0.3 (0.0-3,2) | 56 (53–59) | 0.01 (0.00-0.12) | 1.8 (1.7-1.9) |