Trial reportBMJ open2015
Diagnostic performance of reproducible chest wall tenderness to rule out acute coronary syndrome in acute chest pain: a prospective diagnostic study.
Trial report in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01724996 (Usefulness of Chest Wall Tenderness as Bedside Test to Exclude Acute Coronary Syndrome in Different Demographic Groups), which is not on this map. Cited by 8 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Usefulness of Chest Wall Tenderness as Bedside Test to Exclude Acute Coronary Syndrome in Different Demographic Groups
Who cites it
8 citing papers in PubMed, 3 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Diagnostic accuracy of signs and symptoms in acute coronary syndrome and acute myocardial infarction.Scandinavian journal of primary health care · 2025Pooled it
- Effect of CYP2C19 genetic polymorphism on the pharmacodynamics and clinical outcomes for patients treated with ticagrelor: a systematic review with qualitative and quantitative meta-analysis.BMC cardiovascular disorders · 2022Pooled it
- Pooled it
- An Unusual Case of Denervation Changes of the Intercostal Muscles Associated with Intercostal Neuralgia in a Patient with Chest Pain.Acta medica Lituanic · 2024Article
- Role of CT and MRI in Cardiac Emergencies.Tomography (Ann Arbor, Mich.) · 2022Review
- An unusual presentation of acute myocardial infarction in physiotherapy direct access: findings from a case report.Archives of physiotherapy · 2021Article
- A patient presenting painful chest wall swelling: Tietze syndrome.World journal of emergency medicine · 2019Article
- ANMCO-SIMEU Consensus Document: in-hospital management of patients presenting with chest pain.European heart journal supplements : journal of the European Society of Cardiology · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesAcute chest pain (ACP) is a leading cause of hospital emergency unit consultation. As there are various underlying conditions, ranging from musculoskeletal disorders to acute coronary syndrome (ACS), thorough clinical diagnostics are warranted. The aim of this prospective study was to assess whether reproducible chest wall tenderness (CWT) on palpation in patients with ACP can help to rule out ACS.
methodsIn this prospective, double-blinded diagnostic study, all consecutive patients assessed in the emergency unit at the University Hospital Zurich because of ACP between July 2012 and December 2013 were included when a member of the study team was present. Reproducible CWT on palpation was the initial step and was recorded before further examinations were initiated. The final diagnosis was adjudicated by a study-independent physician.
results121 patients (60.3% male, median age 47 years, IQR 34-66.5 years) were included. The prevalence of ACS was 11.6%. Non-reproducible CWT had a high sensitivity of 92.9% (95% CI 66.1% to 98.8%) for ACS and the presence of reproducible CWT ruled out ACS (p=0.003) with a high negative predictive value (98.1%, 95% CI 89.9% to 99.7%). Conversely non-reproducible CWT ruled in ACS with low specificity (48.6%, 95% CI 38.8% to 58.5%) and low positive predictive value (19.1%, 95% CI 10.6% to 30.5%).
conclusionsThis prospective diagnostic study supports the concept that reproducible CWT helps to rule out ACS in patients with ACP in an early stage of the evaluation process. However, ACS and other diagnoses should be considered in patients with a negative CWT test. TRIAL REGISTRATION NUMBER: ClinicalTrial.gov: NCT01724996.
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