ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2012
Ruling out coronary heart disease in primary care: external validation of a clinical prediction rule.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Pooled it
- The Diagnosis of Chronic Coronary Heart Disease.Deutsches Arzteblatt international · 2017Pooled it
- Causes of chest pain in primary care--a systematic review and meta-analysis.Croatian medical journal · 2015Pooled it
- Acute Coronary Syndrome Risk Prediction Using Portable Cable-Free ECG Device Combined With Clinical Risk Assessment.JACC. Advances · 2026Article
- Navigating chest pain online: who uses health information and what actions follow?BMC primary care · 2025Article
- Evaluating the Efficacy of the Marburg Heart Score to Triage Patients Presenting With Chest Pain in an Emergency Department: A Prospective, Multicenter, Observational Study.Emergency medicine international · 2025Article
- Article
- Evaluation of the Marburg Heart Score and INTERCHEST score compared to current telephone triage for chest pain in out-of-hours primary care.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2023Article
- Article
- Recent developments in diagnosis and risk stratification of non-ST-elevation acute coronary syndrome.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2020Review
- Article
- A Nationwide Flash-Mob Study for Suspected Acute Coronary Syndrome.Annals of family medicine · 2019Observational
- Solving the Diagnostic Challenge: A Patient-Centered Approach.Annals of family medicine · 2018Review
- Early health technology assessment of future clinical decision rule aided triage of patients presenting with acute chest pain in primary care.Primary health care research & development · 2018Article
- The Importance of Ergometry Was Underrated.Deutsches Arzteblatt international · 2018Article
- Review
- Chest pain for coronary heart disease in general practice: clinical judgement and a clinical decision rule.The British journal of general practice : the journal of the Royal College of General Practitioners · 2015Article
- Chest pain out-of-hours - an interview study of primary care physicians' diagnostic approach, tolerance of risk and attitudes to hospital admission.BMC family practice · 2014Article
- Article
- Diagnostic characteristics and prognoses of primary-care patients referred for clinical exercise testing: a prospective observational study.BMC family practice · 2014Observational
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Marburg Heart Score (MHS) aims to assist GPs in safely ruling out coronary heart disease (CHD) in patients presenting with chest pain, and to guide management decisions.
aimTo investigate the diagnostic accuracy of the MHS in an independent sample and to evaluate the generalisability to new patients. DESIGN AND
settingCross-sectional diagnostic study with delayed-type reference standard in general practice in Hesse, Germany.
methodFifty-six German GPs recruited 844 males and females aged ≥ 35 years, presenting between July 2009 and February 2010 with chest pain. Baseline data included the items of the MHS. Data on the subsequent course of chest pain, investigations, hospitalisations, and medication were collected over 6 months and were reviewed by an independent expert panel. CHD was the reference condition. Measures of diagnostic accuracy included the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, likelihood ratios, and predictive values.
resultsThe AUC was 0.84 (95% confidence interval [CI] = 0.80 to 0.88). For a cut-off value of 3, the MHS showed a sensitivity of 89.1% (95% CI = 81.1% to 94.0%), a specificity of 63.5% (95% CI = 60.0% to 66.9%), a positive predictive value of 23.3% (95% CI = 19.2% to 28.0%), and a negative predictive value of 97.9% (95% CI = 96.2% to 98.9%).
conclusionConsidering the diagnostic accuracy of the MHS, its generalisability, and ease of application, its use in clinical practice is recommended.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.