Diagnostic metrics by cohort for ESC-rule-in overall 99th percentile threshold
| Cohort | AMI | Not AMI | Proportion not low risk (%) | Sensitivity (%) | Specificity (%) | Negative predictive value (%) | Positive predictive value (%) | |
|---|---|---|---|---|---|---|---|---|
| hs-cTnI | ||||||||
| Brisbane ADAPT | Test positive | 10 | 5 | 6.0 | 66.7 (38.3 to 88.2) | 97.9 (95.1 to 99.3) | 97.9 (95.1 to 99.3) | 66.7 (38.4 to 88.2) |
| Test negative | 5 | 231 | ||||||
| Christchurch ADAPT | Test positive | 47 | 7 | 13.2 | 60.3 (48.5 to 71.2) | 97.9 (95.7 to 99.1) | 91.3 (87.8 to 93.9) | 87.0 (75.1 to 94.6) |
| Test negative | 31 | 324 | ||||||
| Christchurch ADAPT-ADP | Test positive | 21 | 1 | 9.3 | 75.0 (55.1 to 89.3) | 99.5 (97.4 to 100) | 96.7 (93.4 to 98.7) | 95.5 (77.2 to 99.9) |
| Test negative | 7 | 208 | ||||||
| Christchurch EDACS | Test positive | 6 | 1 | 7.0 | 75.0 (34.9 to 96.8) | 98.9 (94.1 to 100) | 97.8 (92.4 to 99.7) | 85.7 (42.1 to 99.6) |
| Test negative | 2 | 91 | ||||||
| Hamilton RING | Test positive | 2 | 4 | 9.4 | 66.7 (9.4 to 99.2) | 93.4 (84.1 to 98.2) | 98.3 (90.9 to 100) | 33.3 (4.3 to 77.8) |
| Test negative | 1 | 57 | ||||||
| hs-cTnT | ||||||||
| Brisbane ADAPT | Test positive | 10 | 3 | 5.1 | 62.5 (35.4 to 84.8) | 98.7 (96.3 to 99.8) | 97.5 (94.6 to 99.1) | 76.9 (46.2 to 95.0) |
| Test negative | 6 | 234 | ||||||
| Christchurch ADAPT | Test positive | 35 | 10 | 10.4 | 40.2 (29.9 to 51.3) | 97.1 (94.7 to 98.6) | 86.5 (82.7 to 89.8) | 77.8 (62.9 to 88.9) |
| Test negative | 52 | 334 | ||||||
| Christchurch ADAPT-ADP | Test positive | 25 | 7 | 13.5 | 89.3 (71.8 to 97.7) | 96.7 (93.2 to 98.6) | 98.5 (95.8 to 99.7) | 78.1 (60.0 to 99.7) |
| Test negative | 3 | 202 | ||||||
| Hamilton RING | Test positive | 2 | 8 | 15.6 | 66.7 (9.4 to 99.2) | 86.7 (75.8 to 94.2) | 98.1 (90.1 to 100) | 20.0 (2.5 to 55.6) |
| Test negative | 1 | 53 | ||||||
Bold text represents primary outcome metrics.
ESC-rule-in: absolute change of ≥50% the 99th percentile at 3 h in patients with a 0 h hs-cTnI concentration ≤99th percentile and a relative change of ≥20% at 3 h in patients with a 0 h hs-cTnI concentration >99th percentile.
ADP, Accelerated Diagnostic Pathway; AMI, acute myocardial infarction; ESC, European Society of Cardiology; hs-cTnI, high-sensitivity cardiac troponin I; hs-cTnT, high-sensitivity cardiac troponin T.