Systematic review, meta-analysis and economic modelling of ...

Assessment of diagnostic and prognostic accuracyTABLE 30 Quality assessment of exercise ECG prognostic studiesStudy Q1 Q2 Q3 Q4 Q5 Q6 Q7Amsterdam 2002 138 N Y Y Y Y N NDe Filippi 2001 139 Y Y Y Y Y N NDiercks 2000 140 N Y Y Y Y a N NGomez 1996 141 N Y Y Y Y N NGoodacre 2005 142 Y Y Y Y Y N NJeetley 2006 143 N Y Y Y Y N NKerns 1993 144 N Y Y Y Y N NKirk 1998 145 N Y Y Y Y N NLewis 1994 146 N Y Y Y Y N NPolanczyk 1998 147 N Y Y Y Y N NRamakrishna 2005 148 N Y Y Y Y N NSarullo 2000 149 N Y Y Y Y N NTsakonis 1991 150 N Y N Y Y N NN, no; U, unclear; Y, yes.a ‘Y’ at 6 months, ‘N’ at 1 year.Questions:Q1 Are inclusion criteria defined?Q2 Are characteristics described (age and sex)?Q3 Is a MACE defined in the methods section?Q4 Is a MACE identification and definition independent of the index test?Q5 Is a MACE outcome recorded for at least 80% of the cohort from baseline episode?Q6 Was a multivariate analysis undertaken?Q7 Was troponin measured and included in the multivariate analysis?8.0 (95% Crl 2.3 to 22.7) for positive compared with inconclusive or negative test. The CrIs aroundthese estimates were relatively wide but did not include one (i.e. no association). We therefore identifiedevidence that exercise ECG predicts MACEs in patients with suspected ACS, although this finding may belimited by the inclusion of process outcomes (revascularisation procedures) in the definition of MACEs insome studies.78NIHR Journals Library