Diagnostic metrics by cohort for the 99th percentile 0 and 3 h rule-out test
| Cohort | AMI | Not AMI | Proportion low risk (%) | Sensitivity (%) | Specificity (%) | Negative predictive value (%) | Positive predictive value (%) | |
|---|---|---|---|---|---|---|---|---|
| hs-cTnI | ||||||||
| Brisbane ADAPT | Test positive | 14 | 15 | 88.5 | 93.3 (68.1 to 99.8) | 93.6 (89.7 to 97.9) | 98.2 (95.5 to 96.4) | 48.3 (29.4 to 67.5) |
| Test negative | 1 | 221 | ||||||
| Christchurch ADAPT | Test positive | 74 | 22 | 76.3 | 94.9 (87.4 to 98.6) | 93.4 (90.1 to 95.8) | 98.7 (96.7 to 99.7) | 77.1 (67.4 to 85.0) |
| Test negative | 4 | 309 | ||||||
| Christchurch ADAPT-ADP | Test positive | 24 | 12 | 84.8 | 85.7 (67.3 to 96.0) | 94.2 (90.2 to 97.0) | 98.0 (95.0 to 99.5) | 66.7 (49.0 to 81.4) |
| Test negative | 4 | 197 | ||||||
| Christchurch EDACS-ADP | Test positive | 8 | 4 | 88.0 | 100 (51.8 to 100) | 95.7 (89.2 to 98.8) | 100 (93.8 to 100) | 66.7 (34.9 to 90.1) |
| Test negative | 0 | 88 | ||||||
| Hamilton RING | Test positive | 3 | 7 | 84.4 | 100 (19.4 to 100) | 88.5 (77.8 to 95.2) | 100 (90.3 to 100) | 30.0 (6.7 to 65.2) |
| Test negative | 0 | 54 | ||||||
| hs-cTnT | ||||||||
| Brisbane ADAPT | Test positive | 15 | 38 | 79.1 | 93.8 (69.8 to 99.8) | 84.0 (78.7 to 88.4) | 99.5 (97.2 to 100) | 28.3 (16.9 to 42.3) |
| Test negative | 1 | 199 | ||||||
| Christchurch ADAPT | Test positive | 82 | 86 | 61.0 | 94.3 (87.1 to 98.1) | 75.0 (70.1 to 79.5) | 98.1 (95.6 to 99.4) | 48.8 (41.0 to 56.6) |
| Test negative | 5 | 258 | ||||||
| Christchurch ADAPT-ADP | Test positive | 27 | 27 | 77.2 | 96.4 (81.7 to 100) | 87.0 (81.8 to 91.3) | 99.5 (97.0 to 100) | 50.0 (36.1 to 63.9) |
| Test negative | 1 | 182 | ||||||
| Hamilton RING | Test positive | 3 | 19 | 65.6 | 100 (19.4 to 100) | 68.9 (55.7 to 80.1) | 100 (87.7 to 100) | 13.6 (2.9 to 34.9) |
| Test negative | 0 | 42 | ||||||
Bold text represents primary outcome metrics.
99th percentile rule-out: 0 and 3 h hs-cTnI <99th percentile.
ADP, Accelerated Diagnostic Pathway; AMI, acute myocardial infarction; hs-cTnI, high-sensitivity cardiac troponin I; hs-cTnT, high-sensitivity cardiac troponin T.