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Assessment of diagnostic and prognostic accuracyTABLE 11 Population characteristics of studies of IMAStudy Study typePopulation: age (years);sex Inclusion criteria Exclusion criteriaTime fromsymptoms(hours)No. ofpatientsChristenson Multicentre, USA Mean age 59.1 (SD 14.8);2001 61 112 (50%) maleArrival at ED within 3 hours of clinicalsigns and symptoms of ACSMI > 3 hours before presentation,inconsistencies between cTnI andother biochemical marker data inthe 6- to 24-hour time frame< 3 hours 224Collinson 2006 48 Single centre, UK Median age 51.9; 335 (62%)maleAdmissions to the ED withundifferentiated chest painSignificant new ECG changes,requiring hospital admission, knownCAD with unstable angina, clearlynon-cardiac chest pain6 (median) 538Hjortshoj 2010 68 Single centre, UK Median range across threegroups (60–63); 70 (65%)maleChest pain and suspected of ACS None reported Not stated 107Keating 2006 70 Multicentre, UK Median age 61; 251/399eligible (63%) malePossible ischaemic cardiac chest painand normal ECGPain > 8 hours on admission,pain ceased > 2 hours previously,pregnant, renal replacementtherapy, jaundiceNot stated 27742NIHR Journals Library
DOI: 10.3310/hta17010 Health Technology Assessment 2013 Vol. 17 No. 1TABLE 12 Index and reference standard tests used in studies of IMAStudy Index test analyser Threshold Reference test assay and timingChristenson 2001 61 Albumin Cobalt Binding (ACBTM)Test (Ischemia Technologies, Denver,CO, USA) on a Cobas MIRA Plusinstrument75 U/ml Vitros ECi, Abbott AxSYM or Dimension RxL TnIat 6–24 hoursCollinson 2006 48 ACB assay (Ischemia Technologies,Denver, CO, USA)85 U/ml Roche Elecsys TnT or Beckman Coulter TnI up to72 hoursHjortshoj 2010 68 ACB test (Inverness MedicalInnovations Inc., Stirling, UK) on aCobas MIRA Plus instrument88.2 U/ml and91 U/mlRoche Elecsys TnT after 6–9 hours, and12–24 hoursKeating 2006 70 Beckman LX 20 86 U/ml TnI; Beckman Access; taken at least 8 hours afterpain onsetReference Tn diagnosticthreshold (µg/l)MI prevalence insample (%)0.8, 1.6 and 1.5, respectively 130.05 70.03 330.06 15© Queen’s Printer and Controller of HMSO 2013. This work was produced by Goodacre et al. under the terms of a commissioning contract issued by the Secretary of Statefor Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journalsprovided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should beaddressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton SciencePark, Southampton SO16 7NS, UK.43
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Health Technology AssessmentVOLUME
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DOI: 10.3310/hta17010 Health Techno
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ContentsAppendix 5 Expected discoun
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Page 22 and 23: BackgroundTABLE 1 Hospital admissio
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Page 26 and 27: BackgroundComputed tomographic coro
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Discussionspecificity were 62% (95%
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Discussionneed for revascularisatio
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Discussionchanges in sensitivity an
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Discussionuncertainty about these p
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Discussiontroponin assays have bett
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ConclusionsSuggested research prior
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Appendix 144. heart-type fatty acid
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Appendix 1135. interleukin 33.mp. (
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Appendix 9Clinical diagnosis of NST
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Appendix 9respectively. Exercise EC
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Appendix 93. Two reviewers will mak
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Appendix 9The methodology used in t
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Appendix 9ES (Information Resources
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Appendix 923. Westwood ME, Whiting
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