Evidence map›Paper›PMID 42470147›Full record

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

Validation of a 0/2-Hour Point-Of-Care High Sensitivity Troponin Algorithm: A Multisite US Study.

Simon A Mahler, Nicklaus P Ashburn, Akalya Villenthi, David A Pearson, Hannah D Pugh, Benjamin T Hutchison, Michael W Supples, Anna C Snavely

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

Article 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 NCT06899776 (Assessing Chest Pain Using Point-of-Care High-Sensitivity Troponin I in the Emergency Department), 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.

NCT06899776 active not recruitingnot on this map

Assessing Chest Pain Using Point-of-Care High-Sensitivity Troponin I in the Emergency Department

TypeobservationalSponsorWake Forest University Health SciencesRan2025 to 2026Enrolled600ConditionsACS (Acute Coronary Syndrome)ArmsAbbott i-STAT point of care (POC) device
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Validation of a 0/2-Hour Point-Of-Care High Sensitivity Troponin Algorithm: A Multisite US Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026
    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

8 authors.

Simon A MahlerDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Nicklaus P AshburnDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.ORCID 0000-0002-3466-8813
Akalya VillenthiDepartment of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
David A PearsonDepartment of Emergency Medicine, Carolinas Medical Center, Charlotte, North Carolina, USA.
Hannah D PughDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Benjamin T HutchisonDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Michael W SupplesDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
Anna C SnavelyDepartment of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.

Funding

Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
Initiating Preventive Care for Hyperlipidemia in the Emergency Department: The EMERALD TrialK23HL169929 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Nicklaus P Ashburn · 2024 to 2026
$468k
AHRQ HHS R01 HS029017AHRQ HHS R21 HS029234NCATS NIH HHS UL1 TR001420NHLBI NIH HHS K23 HL169929
6 · The paper itself

Abstract

objectivesA 0/2-h algorithm for the i-STAT point-of-care (POC) high sensitivity troponin I (hs-cTnI) assay was recently derived in Australia. The objective of this study was to validate and optimize the performance of the 0/2-h algorithm in a multisite U.S. Emergency Department (ED) cohort.

methodsA prospective cohort study was conducted at three U.S. EDs (February-September 2025). Adults without STEMI and at least one hs-cTnI ordered were accrued. Blood samples were collected simultaneously for POC hs-cTnI measurement on an i-STAT 1 analyzer (Abbott Laboratories) and central laboratory hs-cTnI measurement (Beckman Coulter). The primary outcome was index myocardial infarction (MI), adjudicated by experts using clinical hs-cTnI measures. Diagnostic performance of the Australian 0/2-h algorithm was assessed by calculating negative and positive predictive values (NPV, PPV) with associated 95% confidence intervals. Efficacy, defined as the proportion of patients classified into the rule-out zone, was calculated. Algorithm optimization tested modified cut points to increase efficacy while maintaining NPV ≥ 99% and achieving PPV ≥ 65%.

resultsDuring the study period, 578 patients with complete 0/2-h algorithm assessments were accrued. These patients were 48% (279/578) female, 40% (233/578) non-White, with a median age of 60 years (IQR: 50-70). Index MI occurred in 7.4% (43/578). Algorithm efficacy was 54.8% (317/578) and 8.8% (51/578) were classified to the rule-in zone. Among patients ruled-out, the NPV was 99.4% (95% CI: 97.7%-99.9%). The rule-in zone was associated with a PPV of 62.7% (95% CI: 48.1%-75.9%). Among 36.3% (210/578) patients classified to the observation zone, 4.3% (9/210) had an adjudicated index MI. An optimized 0/2-h algorithm increased efficacy to 60.0% (347/578) while achieving an NPV of 99.4% (95% CI: 97.9%-99.9%) and PPV of 74.4% (95% CI: 58.8, 86.5%) for index MI.

conclusionsThe original Australian and optimized 0/2-h algorithms for i-STAT POC hs-cTnI measurement had high NPV and efficacy in a multisite U.S. COHORT:

trial registrationTrial Registration: NCT06899776.

Indexed as

AlgorithmsMyocardial InfarctionPoint-of-Care SystemsTroponin IAgedBiomarkersEmergency Service, HospitalFemaleHumansMaleMiddle AgedPredictive Value of TestsProspective StudiesRapid Diagnostic TestsUnited StatesBiomarkersTroponin Ichest painhigh sensitivity troponinlength of staymyocardial infarctionpoint‐of‐care

Identifiers

PMID42470147
PMCPMC13379726

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

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.