ArticlePloS one2017
Economic evaluation of the one-hour rule-out and rule-in algorithm for acute myocardial infarction using the high-sensitivity cardiac troponin T assay in the emergency department.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- High-sensitivity troponin assays for early rule-out of acute myocardial infarction in people with acute chest pain: a systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2021Pooled it
- Type 1 and type 2 NSTEMI in atrial fibrillation: insights from the HERA-FIB registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- Cost-effectiveness of prehospital high-sensitivity troponin i testing versus standard emergency department care in patients with suspected acute coronary syndrome in France.Health economics review · 2026Article
- Performance Evaluation of the 2020 European Society of Cardiology 0-hour/1-hour Algorithm Using High-sensitivity Cardiac Troponin I for Non-ST-segment Elevation Acute Coronary Syndrome and Mortality Assessment Based on 1-year Real-world Data.Annals of laboratory medicine · 2026Article
- Comparative Analysis of Single- and Dual-Marker Strategies for Rapid Non-ST-Segment-Elevation Myocardial Infarction Rule-Out Using Cardiac Myosin-Binding Protein C, Copeptin, and High-Sensitivity Cardiac Troponin T in the Emergency Department.Journal of the American Heart Association · 2025Observational
- Improved Utilization of Serial Testing Without Increased Admissions after Implementation of High-Sensitivity Troponin I: a Controlled Retrospective Cohort Study.Journal of general internal medicine · 2024Article
- Is rapid acute coronary syndrome evaluation with high-sensitivity cardiac troponin less costly? An economic evaluation.Journal of the American College of Emergency Physicians open · 2024Article
- Management of myocardial infarction with non-obstructive coronary arteries (MINOCA) in Germany: a single-center study on hospital resources and healthcare economics.Frontiers in public health · 2024Article
- Real-World Evidence on Disparities on the Initiation of Ticagrelor Versus Prasugrel in Patients With Acute Coronary Syndrome.Journal of the American Heart Association · 2023Observational
- Time for implementing high-sensitivity cardiac troponin assays in emergency departments in Italy.Internal and emergency medicine · 2023Article
- Advantage of Using of High-Sensitivity Troponin I Compared to Conventional Troponin I in Shortening Time to Rule out/in Acute Coronary Syndrome in Chest Pain Patients Presenting to the Emergency Department.Medicina (Kaunas, Lithuania) · 2022Observational
- A 0/1h-algorithm using cardiac myosin-binding protein C for early diagnosis of myocardial infarction.European heart journal. Acute cardiovascular care · 2022Article
- Impact of a rapid high-sensitivity troponin pathway on patient flow in an urban emergency department.Journal of the American College of Emergency Physicians open · 2022Article
- Evaluation of a cardiac troponin process flow at the chest pain center with the shortest turnaround time.Journal of clinical laboratory analysis · 2022Article
- Cost effectiveness of a 1-hour high-sensitivity troponin-T protocol: An analysis of the RAPID-TnT trial.International journal of cardiology. Heart & vasculature · 2022Article
- Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
- Downstream Cascades of Care Following High-Sensitivity Troponin Test Implementation.Journal of the American College of Cardiology · 2021Observational
- Diagnostic Reclassification by a High-Sensitivity Cardiac Troponin Assay.Annals of emergency medicine · 2020Observational
- Observational
- 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
Corrections and comments
- Erratum issued
Authors and funding
12 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundThe 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown. METHODS AND
findingsWe performed a post-hoc economic analysis in a large, diagnostic, multicenter study of hs-cTnT using central adjudication of the final diagnosis by two independent cardiologists. Length of stay (LoS), resource utilization (RU), and predicted diagnostic accuracy of the 1-h algorithm compared to standard of care (SoC) in the ED were estimated. The ED LoS, RU, and accuracy of the 1-h algorithm was compared to that achieved by the SoC at ED discharge. Expert opinion was sought to characterize clinical implementation of the 1-h algorithm, which required blood draws at ED presentation and 1h, after which "rule-in" patients were transferred for coronary angiography, "rule-out" patients underwent outpatient stress testing, and "observation" patients received SoC. Unit costs were for the United Kingdom, Switzerland, and Germany. The sensitivity and specificity for the 1-h algorithm were 87% and 96%, respectively, compared to 69% and 98% for SoC. The mean ED LoS for the 1-h algorithm was 4.3h-it was 6.5h for SoC, which is a reduction of 33%. The 1-h algorithm was associated with reductions in RU, driven largely by the shorter LoS in the ED for patients with a diagnosis other than AMI. The estimated total costs per patient were £2,480 for the 1-h algorithm compared to £4,561 for SoC, a reduction of up to 46%.
conclusionsThe analysis shows that the use of 1-h algorithm is associated with reduction in overall AMI diagnostic costs, provided it is carefully implemented in clinical practice. These results need to be prospectively validated in the future.
Indexed as
Identifiers
What OpenQuestion holds
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.