Table 4
| Author, date and country | Patient group | Study type (level of evidence) | Outcomes | Key results | Study weaknesses |
|---|---|---|---|---|---|
| McGuinness JB et al, 1976, Scotland | 898 patients admitted to CCU. | Prospective diagnostic cohort | Sensitivity of initial | 51% | |
| 400 with AMI. | ECG | ||||
| Starck M and Vacek JL, 1987, USA | 221 ED chest pain patients. 39 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 62% | Air Force hospital, possible selection bias. |
| ECG | No raw cardiac enzyme data confirming how AMI diagnosed. | ||||
| Sharkey SW et al, 1988, USA | 34 patients admitted to CCU. 34 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 61% | CCU population not ED. |
| ECG | Small population size. | ||||
| Fesmire F et al, 1989, USA | 440 ED chest pain patients. 100 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 47% | No evidence of timing of the initial ECG. |
| ECG | |||||
| Rouan G et al, 1989, USA | 918 ED chest pain patients. 811 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 13% | Interrator agreement of ECG interpretation not measured from separate participating ED. |
| ECG | |||||
| Inclusion of AMI and ischaemic ECG changes. | |||||
| Gibler B et al, 1992, USA | 616 ED chest pain patients. 108 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 36% | Recruitment criteria unclear. |
| ECG | Unclear if series or selection of patients recruited | ||||
| Young P and Green T, 1993, USA | 222 ED chest pain patients. 43 with AMI. | Retrospective survey | Sensitivity of initial | 28% | Retrospective study. |
| ECG | Study population mostly elderly | ||||
| Zalenski R et al, 1993, USA | 149 ED chest pain patients. 34 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 47.1% | Small population |
| ECG | |||||
| Fesmire F, 1998, USA | 1000 ED chest pain patients. 204 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 55.4% | ? 34 patients had AMI following admission to ED. |
| ECG | |||||
| Kudenchuk PJ et al, 1998, USA | 3027 ED chest pain patients. 1149 with AMI. | Prospective diagnostic cohort | Sensitivity of initial | 69% | Initial ECG taken by paramedics, not in ED. |
| ECG |
