ArticleEmergency medicine journal : EMJ2021
Prehospital risk stratification in patients with chest pain.
Article in Emergency medicine journal : EMJ, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 15 papers.
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.
Prehospital Triage of Patients With Suspected Non-ST-segment Elevation Acute Coronary Syndrome: the TRIAGE-ACS Study
Individual Patient Data Meta-analysis on Prehospital Risk Assessment in Patients Suspected of Non-ST-segment Elevation Acute Coronary Syndrome
Who cites it
15 citing papers in PubMed.
- Pre-hospital rule-out of non-ST-segment elevation acute coronary syndrome by a single troponin: final one-year outcomes of the ARTICA randomised trial.European heart journal. Quality of care & clinical outcomes · 2024Trial
- Rule-out of non-ST-segment elevation acute coronary syndrome by a single, pre-hospital troponin measurement: a randomized trial.European heart journal · 2023Trial
- Undifferentiated Prehospital Chest Pain: Aetiologies and a Proof-of-Concept Model for Significant Coronary Lesions.Journal of clinical medicine · 2026Article
- Bridging the black box: artificial intelligence in acute care needs greater interpretability and precision.BMJ health & care informatics · 2026Article
- Technology and evidence in daily cardiovascular practice.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Article
- Agreement between ambulance paramedics and physicians on the (pre)hospital identification of low-risk chest pain patients.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2026Article
- Impact of Prehospital Administration of Aspirin and Unfractionated Heparin on In-Hospital Outcomes in Patients with Suspected Myocardial Infarction: A Retrospective Cohort Study.Open access emergency medicine : OAEM · 2026Article
- Brazilian Guideline for the Evaluation and Diagnosis of Chest Pain in the Emergency Department - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Adequately identifying low-risk chest pain in emergency primary care: evaluating the performance of preHEAR(T) based on two European cohorts.Open heart · 2025Article
- Towards prehospital risk stratification using deep learning for ECG interpretation in suspected acute coronary syndrome.BMJ health & care informatics · 2025Article
- How Close Are We to Patient-Side Troponin Testing?Journal of clinical medicine · 2024Review
- Preclinical identification of acute coronary syndrome without high sensitivity troponin assays using machine learning algorithms.Scientific reports · 2024Article
- Differences in risk and costs between prehospital identified low-risk men and women with chest pain.Open heart · 2023Article
- Direct admission versus interhospital transfer for revascularisation in non-ST-segment elevation myocardial infarction.Clinical cardiology · 2023Article
- Development of a machine-learning algorithm to predict in-hospital cardiac arrest for emergency department patients using a nationwide database.Scientific reports · 2022Observational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
23 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe History, ECG, Age, Risk Factors and Troponin (HEART) Score is a decision support tool applied by physicians in the emergency department developed to risk stratify low-risk patients presenting with chest pain. We assessed the potential value of this tool in prehospital setting, when applied by emergency medical services (EMS), and derived and validated a tool adapted to the prehospital setting in order to determine if it could assist with decisions regarding conveyance to a hospital.
methods
resultsAmong 1208 patients prospectively recruited in the first cohort, 123 patients (10.2%) developed a MACE. The HEART Score had a negative predictive value (NPV) of 98.4% (96.4-99.3), a positive predictive value (PPV) of 35.5% (31.8-39.3) and an area under the receiver operating characteristic curve (AUC) of 0.81 (0.78-0.85). The preHEART Score had an NPV of 99.3% (98.1-99.8), a PPV of 49.4% (42.0-56.9) and an AUC of 0.85 (0.82-0.88), outperforming the HEART Score or POC troponin measurements on their own. Similar results were found in a validation cohort.
conclusionsThe HEART Score can be used in the prehospital setting to assist with conveyance decisions and choice of hospitals; however, the preHEART Score outperforms both the HEART Score and single POC troponin measurements when applied by EMS personnel in the prehospital setting.
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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.