What's Better for Predicting MI — a Risk Score or Your Clinical Judgment?

Only clinician gestalt and the TIMI score had a zero miss rate.

A 2015 European paper compared myocardial infarction (MI) risk scores combined with high-sensitivity troponin (hsTn) testing, to assess their ability to rule out MI (NEJM JW Emerg Med Jan 2016 and Ann Emerg Med 2015; 66:635). In my summary of that paper, I commented that the results were not generalizable, and lamented that clinician gestalt was not compared to the risk scores. Now U.S. investigators compared MI risk scores among chest-pain patients presenting to one of seven emergency departments (EDs) who had at least one conventional troponin (cTn) measurement. The following scores were calculated prospectively: Thrombolysis in Myocardial Infarction (TIMI); Global Registry of Acute Cardiac Events (GRACE); History, ECG, Age, Risk Factors,…

Reviewing Author

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals

Daniel J. Pallin, MD, MPH

Disclosures

Consultant/Advisory BoardPortola Pharmaceuticals, Inc.

Speaker’s BureauPeerView Institute for Medical Education

What's Better for Predicting MI — a Risk Score or Your Clinical Judgment?

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Reviewing Author