| Title: |
Clinical decision aids and computed tomography coronary angiography in patients with suspected acute coronary syndrome |
| Authors: |
Wang, Kang-Ling; Taggart, Caelan; McDermott, Michael; O'Brien, Rachel; Oatey, Katherine; Keating, Liza; Storey, Robert F; Felmeden, Dirk; Curzen, Nick; Kardos, Attila; Roobottom, Carl; Smith, Jason; Goodacre, Steve; Newby, David E; Gray, Alasdair J; on behalf of the RAPID-CTCA Investigators; O’Brien, Rachel; Smith, Jason E; Coats, Tim; Gray, Alasdair; Lewis, Steff; Archibald, Kenneth; Bell, Graham; Mycock, Rodney; Bull, Russell; McCann, Gerry; Mittal, Tarun; Rudd, James; Gamble, Carrol; Carley, Simon; Padley, Prof Simon; Mills, Nicholas; Shah, Anoop; Chapman, Andrew; Morgan-Hughes, Gareth; Raju, Vikram; Luke, Kym; Black, Alasdair Gray –Polly; Blackstock, Caroline; Grahamslaw, Julia; Jones, Mark; Keanie, Collette; MacLeod, Margaret; McLaughlin, Siobhan; Perks, Fergus; Phillips, Alyson; Pirie, Ewan; Summerside, Janet; Truong, Gordon; Weston, Kirsty; Wooton, Jennifer; Bird, Steve Goodacre –Sarah; Brown, Peter; Chatha, Hridesh; Fletcher, Alan; Hill, Catherine; Mofidi, Shery; Qayyum, Hasan; Storey, Robert; Sugden, Judith; Wilson, Anna; Jeffrey, Jason Smith –Alison; Mwadeyi, Memory; Squire, Rosalyn; Archer, Dirk Feldman –Lesley; Felmeden, Lisa; Gribbin, Guy; Harrison, Sarah; Hughes, Debbie; Keeling, Philip; Mahy, Ian; Summerhayes, Allison; Sutton, Justine; Yonis, Abdullah; Kinnon, Andrew; Fowler, Ajay Yerramasu –Susan; McGregor, Amanda; Grey, Karen; Hartley, Tom; Szapiro, David; Dinnel, Lorraine; Sandeman, Dennis; Dean, Robert Huggett –Julie; Pugh, Amy; Bhuie, Liza Keating –Parminder; Briggs, James; Burnett, Claire; Gandy, Abby; Jacques, Nicola; MacGill, Sarah; Speirs, Archie; Tolan, Niamh; Atkinson, Sudantha Bulugahapitiya –Craig; Kon, Mark; Krannila, Carita; Thomas, Manitha; Bull, Jehangir Din –Russell; Horler, Stephanie; Lakeman, Nicki; McLeod, Jane; Nix, Sara; Thomas, Sue; Ahlert, Andrew Mitchell –Daniel; Edmond, Christopher; Hare, Christopher; Kinsella, Kelly Anne; Langtree, Jessica; Speakman, James; Thomas, Ranjit; Donaldson, Anne Scott –Gillian; Hall, Fiona; Fairbairn, Terry; Rofe, Christopher; Adams-Hall, Anna Beattie –Jennifer; Bailey, Ange; Bailey, Kris; Bremner, Leslie; Haq, Ifti; Phillipson, Angela; David, Khalid Alfakih –Saroj; Najam, Osman; Pilgrim, Samia; Adams, Adrian Brady –Claire; Brown, Ammani; Dougherty, Andrew; Geddes, Ailsa; Lang, Karen; Lowe, David; MacDuff, Ross; McGregor, Lorraine; Roditi, Giles; Thornton, Susan; Triscott, Joyce; Adjei, Attila Kardos –Felicia; Colda, Antoanela; Chapman, Caitlin; Edgell, Veronica; Fell, Michael; Halmai, Laszlo; Khan, Aarzoo; Northfield, John; Padilla-Harris, Cheryl; Pashler, Mike; Richie, Gill; Scaletta, Diane; Sunderland, Sarah–Beth; Turner, Joanne; Vickery, Lois; Walia, Sonya; Williams, Felicity; Wren, Lynn; Wright, Nicola; Maguire, Hefin Jones –Holly; Varquez, Resti; D’Sa, Derek Connolly –Anthony; Sharma, Vinoda; Turner, Ashley; Bell, Ronak Rajani –Megan; Benedetti, Giulia; Gibson, Kirsty; Mak, Sze Mun; Preston, Rebecca; Raynsford, Amy; Sanchez-Vidal, Ruth; Muthusamy, Rangasamy; Biggins, Simon Smith –Susan; Dixon, Kathryn; Kraut, Peter; Lawan, Mwada; Murray, Victoria; Mwambingu, Tom; Walker, Rachel; Weston, Carol; Byrom-Goulthorp, Abdel-Rahman Saif-El-Dean –Roo; Darby, Michael; Ikongo, Eunice; Johnstone, Annette; Lin, Alan; Albutt, Ben Holloway –Tania; Dawson, Vicky; Dowling, Claire; Isaacs, Karen; Kaila, Cheyanne; Lewis, Gareth; Mortimer, Nicky; San, Sunitha; Tabor, Kelly; Wright, Kealy; Ahmed, Ansuman Saha –Riaz; Collins, Sally; Davies, Sarah; Ndlovu, Nokukhanya; Abbas, Nick Curzen –Ausami; Calver, Alison; Corbett, Simon; Cowburn, Peter; Flett, Andrew; Gray, Huon; Harden, Stephen; Haydock, Paul; Mahmoudi, Michael; Paisey, John; Peebles, Charles; Rakhit, Drew; Rawlins, John; Roberts, Paul; Shah, Benoy; Shambrook, James; Simpson, Iain; Sirohi, Rohit; Ullah, Wagas; Vedwan, Katharine; Wilkinson, James; Yue, Arthur; Giannopoulou, Matthias Schmitt –Sarra; Greaves, Melanie; McGlynn, Stephen; Miller, Chris; Murray, Lindsay; Muthuswamy, Akhila; Nicholas, Anie; Gent, Christopher Travill –Susan; Gent, Susan; Hussain, Nafisa; Davies, Ceri; Harris, Tim; Astin-Chamberlain, Ben Bloom –Raine; Bolton, Olivia; Martin, Dan; Noba, Lyrics; Norman, Georgia; Page, Shelley; Power, Helen; Skene, Imogen; Smith, David; Walters, Jon; Doughty, Will Roberts –Angela; Byng-Hollander, Elaine; Routledge, Helen; Hammond, Patrick Donnelly –Leah; Hutchinson, Jayne; Kelly, Stephanie; Regan, Susan; Smith, Aileen; Gray, Justin Carter –Julie; Purvis, Sarah; Race, Pam; Almaden-Boyle, John Irving –Christine; Bissett, Kim; Blues, Carol; Duff, Jackie; Dundas, Scot; Fawcett, Shirley; Houston, Graeme; Hutchison, Emma; Letham, Debbie; Mackintosh, Ann; Meach, Laura; Queripcz, Laura Jayne; Webster, Alan; Atchley, Chris Vorwerk –Julian; Daly, Zoe; Ellinor, Kat; Cowell, Ash Basu –Richard; Craddock, Helen; Hughes, Rachel; Sackett, Lynda; Saul, Victoria; Smith, Fiona; Stockport, Jane; Watkins, Clare; Barden, Jason Dungu –Edward; Colnet, Jackie; Gedeza, Swamy; Hoskin, Laura; Kittridge, Lauren; Maloney, Gracie; McCormick, Claire; Nicholson, Anne; Pepper, Stacey; Riches, Joanne; Sevillano, Annaliza; McAlindon, Elisa; Hothi, Sandeep; Rosewarne, Dr David; Amoah, Arivalagan Bapusamy –Vincent; Aulton, Stacey; Cottam, Victoria; Metherell, Stella; Milgate, Sarah; Radford, Elizabeth; Smallwood, Andy; Barr, Jonathan Watt –Charlotte; Broadie, Jonathan; Eason, David; Logie, Ing-Marie; McDonald, Debbie; O’Keeffe, Laura; Patience, Donna; Patience, Lesley; Ahmad, Claire McGroarty –Faheem; Baxter, Nicola; Byrne, John; Collison, Damien; Hopkins, Tracey; King, Hayley; McLennan, Evonne; Stobo, David; Wilson, Mark; Woodward, Rosie |
| Publisher Information: |
BMJ Publishing Group Ltd |
| Publication Year: |
2024 |
| Collection: |
HighWire Press (Stanford University) |
| Subject Terms: |
Original research |
| Description: |
Background The HEART score, the T-MACS model and the GRACE score support early decision-making for acute chest pain, which could be complemented by CT coronary angiography (CTCA). However, their performance has not been directly compared. Methods In this secondary analysis of a multicentre randomised controlled trial of early CTCA in intermediate-risk patients with suspected acute coronary syndrome, C-statistics and performance metrics (using the predefined cut-offs) of clinical decision aids and CTCA, alone and then in combination, for the index hospital diagnosis of acute coronary syndrome and for 30-day coronary revascularisation were assessed in those who underwent CTCA and had complete data. Results Among 699 patients, 358 (51%) had an index hospital diagnosis of acute coronary syndrome, for which the C-statistic was higher for CTCA (0.80), followed by the T-MACS model (0.78), the HEART score (0.74) and the GRACE score (0.60). The negative predictive value was higher for the absence of coronary artery disease on CTCA (0.90) or a T-MACS estimate of |
| Document Type: |
text |
| File Description: |
text/html |
| Language: |
English |
| Relation: |
http://emj.bmj.com/cgi/content/short/41/8/488; http://dx.doi.org/10.1136/emermed-2024-213904 |
| DOI: |
10.1136/emermed-2024-213904 |
| Availability: |
http://emj.bmj.com/cgi/content/short/41/8/488; https://doi.org/10.1136/emermed-2024-213904 |
| Rights: |
Copyright (C) 2024, British Association for Accident and Emergency Medicine |
| Accession Number: |
edsbas.43182832 |
| Database: |
BASE |