Evidence map›Paper›PMID 41528153›Full record

Observational studyAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2026

Diagnostic Accuracy of a Novel Point of Care High-Sensitivity Troponin Assay in the Prehospital Environment.

John Gilman, Abdulrhman Alghamdi, Mark Hann, Edward Carlton, Jamie G Cooper, Eloïse Cook, Aloysius Niroshan Siriwardena, John Phillips, Alexander Thompson, Steve Bell and 3 more

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03561051 (The Pre-hospital Evaluation of Sensitive Troponin), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT03561051 unknown statusnot on this map

The Pre-hospital Evaluation of Sensitive Troponin (PRESTO) Study

TypeobservationalSponsorManchester University NHS Foundation TrustRan2018 to 2025Enrolled700ConditionsChest Pain, Acute Coronary Syndrome, Heart Attack
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Diagnostic Accuracy of a Novel Point of Care High-Sensitivity Troponin Assay in the Prehospital Environment.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    Observational
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

13 authors.

John GilmanDepartment of Laboratory Medicine, Northern Care Alliance NHS Foundation Trust, Salford, UK.
Abdulrhman AlghamdiCollege of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.ORCID 0000-0002-8292-5212
Mark HannDivision of Population Health, Health Services Research & Primary Care, the University of Manchester, Manchester, UK.
Edward CarltonUniversity of Bristol Medical School, Translational Health Sciences, Southmead Hospital Learning and Research, Bristol, UK.
Jamie G CooperEmergency Department, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK.
Eloïse CookEmergency Department, Manchester University NHS Foundation Trust, Manchester, UK.
Aloysius Niroshan SiriwardenaCommunity and Health Research Unit, School of Health and Social Care, University of Lincoln, Lincoln, UK.
John PhillipsThe Ticker Club (A Cardiac Patient Support Group), Wythenshawe Hospital, Manchester, UK.
Alexander ThompsonDivision of Population Health, Health Services Research & Primary Care, the University of Manchester, Manchester, UK.ORCID 0000-0003-4930-5107
Steve BellMedical Directorate, North West Ambulance Service NHS Foundation Trust, Bolton, UK.ORCID 0000-0003-3891-6623
Kim KirbyCentre for Health and Clinical Research, School of Health and Social Wellbeing, University of the West of England, Bristol, UK.
Andy RosserWest Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill, UK.
Richard BodyEmergency Department, Manchester University NHS Foundation Trust, Manchester, UK.

Funding

Abbott Point of CareNational Institute for Health and Care Research PB-PG-1216-20034
6 · The paper itself

Abstract

objectiveTo evaluate the diagnostic accuracy of a novel point of care (POC) high-sensitivity troponin (hs-cTn) assay, used alone or incorporated within validated decision aids, for acute myocardial infarction (AMI) in the prehospital setting.

methodsA pre-specified secondary analysis of the Prehospital Evaluation of Sensitive Troponin (PRESTO) prospective diagnostic accuracy study, conducted in four ambulance services and 12 Emergency Departments (EDs; February 2019-March 2020). Paramedics included consenting adults with suspected AMI and no other reason for conveyance. Clinical data and venous blood were collected at the scene, and samples conveyed to hospital with participants. Plasma samples were later analyzed for hs-cTn using a novel POC hs-cTn assay (Abbott Point of Care i-STAT hs-TnI). The target condition was an adjudicated index diagnosis of type 1 AMI.

resultsOf 817 consenting participants, 704 were eligible for inclusion in this analysis, with type 1 AMI occurring in 89 (12.6%). At the limit of detection (< 2 ng/L), POC hs-cTn had 100.0% sensitivity (95% CI 95 9%-100.0%) but only 4.6% specificity (95% CI 3.1%-6.5%). A Troponin-only Manchester Acute Coronary Syndromes (T-MACS) very-low risk outcome identified 134 (19.7%) patients for non-conveyance with 98.9% sensitivity (95% CI 94.9%-100.0%), 99.3% negative predictive value (NPV, 95% CI 95.0%-99.9%), and 22.5% specificity (95% CI 19.2%-26.1%). A low-risk modified HEART score identified 150 (22.0%) patients with 93.2% sensitivity (95% CI 85.8%-97.5%), 96.0% NPV (91.6%-98.1%), and 24.3% specificity (95% CI 20.9%-27.9%). In an exploratory analysis, hs-cTn < 5 ng/L identified 295 (41.9%) patients with 98.9% sensitivity (93.9%-100.0%), 99.7% NPV (97.7%-100.0%), and 47.8% specificity (95% CI 43.8%-51.8%).

conclusionsThis novel POC hs-cTn assay achieves high sensitivity and NPV when used alongside the T-MACS decision aid, but efficiency may be greater at a 5 ng/L threshold without requiring any decision aid.

trial registrationClinicalTrials.gov identifier: NCT03561051.

Indexed as

Emergency Medical ServicesMyocardial InfarctionPoint-of-Care SystemsTroponinAdultAgedBiomarkersEmergency Service, HospitalFemaleHumansMaleMiddle AgedProspective StudiesSensitivity and SpecificityBiomarkersTroponinacute coronary syndromesacute myocardial infarctiondiagnosisemergency medical serviceshigh sensitivity troponinsprehospital caresensitivity and specificitytroponins

Identifiers

PMID41528153
PMCPMC12798273

What OpenQuestion holds

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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.