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The Authors' reply
  1. Steve W Goodacre1,
  2. Paul Collinson2,
  3. Alasdair Gray3,
  4. on behalf of the RATPAC Research Team
  1. 1School of Health and Related Research, University of Sheffield, Sheffield, UK
  2. 2Departments of Clinical Blood Sciences and Cardiology, St George's Hospital, London, UK
  3. 3Accident & Emergency Department, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to Professor Steve W Goodacre, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK; s.goodacre{at}

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The Authors' reply The Randomised Assessment of Treatment using Panel Assay of Cardiac Markers (RATPAC) trial was a pragmatic evaluation comparing a specific point-of-care panel assessment to what is still standard diagnostic assessment for suspected myocardial infarction, a 12-hour laboratory troponin. The studies by Keller et al1 and Reichlin et al2 show that modern high sensitivity troponin assays have better sensitivity than older assays but troponin measurement at presentation is still suboptimal compared with delayed measurement. We are currently undertaking an economic analysis to determine whether delayed troponin measurement is cost effective compared with measurement at presentation.3 Until this analysis is undertaken, delayed troponin …

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  • Competing interests None.

  • Provenance and peer review Commissioned; internally peer reviewed.

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