Evidence map›Paper›PMID 34893795›Full record

ArticleAmerican journal of clinical pathology2022

Emergency Department Management of Chest Pain With a High-Sensitivity Troponin-Enabled 0/1-Hour Rule-Out Algorithm.

Nicholas J Bevins, Hyojin Chae, Jacqueline A Hubbard, Edward M Castillo, Vaishal M Tolia, Lori B Daniels, Robert L Fitzgerald

Open access · bronzeAbstract read
In one paragraph

Article in American journal of clinical pathology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
0.8field-weighted citation impact, top 25% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Observational
  3. Historical Review of Acute Myocardial Ischemia Risk Assessment.Hawai'i journal of health & social welfare · 2026
    Review
  4. Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Nicholas J BevinsDepartment of Pathology, University of California San Diego, San Diego, CA, USA.ORCID 0000-0002-8073-5941
Hyojin ChaeDepartment of Laboratory Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Jacqueline A HubbardDepartment of Pathology and Laboratory Medicine, Dartmouth University, Lebanon, NH, USA.ORCID 0000-0003-4092-7153
Edward M CastilloDepartment of Emergency Medicine, University of California San Diego, San Diego, CA, USA.
Vaishal M ToliaDepartment of Emergency Medicine, University of California San Diego, San Diego, CA, USA.
Lori B DanielsDivision of Cardiovascular Medicine, University of California San Diego, San Diego, CA, USA.ORCID 0000-0002-4841-9922
Robert L FitzgeraldDepartment of Pathology, University of California San Diego, San Diego, CA, USA.
University of California San Diego · USThe Catholic University of Korea Seoul St. Mary's Hospital · KR

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
NCATS NIH HHS UL1 TR001442
6 · The paper itself

Abstract

objectivesThe analytical sensitivity of high-sensitivity cardiac troponin T (hsTnT) assays has enabled rapid myocardial infarction rule-out algorithms for emergency department (ED) presentations. Few studies have analyzed the real-world impact of hsTnT algorithms on outcomes and operations.

methodsComparison of ED length of stay (LOS) and 30-day outcomes (return to ED, inpatient admission, and mortality) for patients presenting with chest pain during 2 separate 208-day periods using a 0/1-hour hsTnT-enabled algorithm or fourth-generation TnT.

resultsDischarge, 30-day readmission, and 30-day mortality rates were not significantly different with fourth-generation TnT vs hsTnT. Thirty-day return rates were significantly decreased with hsTnT (17.4% vs 14.9%; P < .01). For encounters with TnT measured at least twice and resulting in discharge, median ED LOS decreased by 61 minutes with the use of hsTnT (488 vs 427 minutes; P < .0001). Median time between first and second TnT results decreased by 82 minutes with hsTnT (202 vs 120 minutes; P < .0001), suggesting that the 0/1-hour algorithm was incompletely adopted.

conclusionsImplementation of the hsTnT algorithm was associated with decreased 30-day return rates and decreased ED LOS for a subset of patients, despite incomplete adoption of the 0/1-hour algorithm.

Indexed as

TroponinTroponin TAlgorithmsBiomarkersChest PainEmergency Service, HospitalHumansBiomarkersTroponinTroponin TAcute myocardial infarctionCardiac biomarkersSensitiveTroponin

Identifiers

PMID34893795
PMCPMC9071328
OpenAlexW4200059237

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.