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  5. Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά) - ΙΑΤ
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Please use this identifier to cite or link to this item: https://olympias.lib.uoi.gr/jspui/handle/123456789/24149
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dc.contributor.authorBalk, E. M.en
dc.contributor.authorIoannidis, J. P.en
dc.contributor.authorSalem, D.en
dc.contributor.authorChew, P. W.en
dc.contributor.authorLau, J.en
dc.date.accessioned2015-11-24T19:38:26Z-
dc.date.available2015-11-24T19:38:26Z-
dc.identifier.issn0196-0644-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/24149-
dc.rightsDefault Licence-
dc.subjectAcute Diseaseen
dc.subjectAngina, Unstable/*blood/*diagnosis/enzymologyen
dc.subjectBias (Epidemiology)en
dc.subjectBiological Markers/*blooden
dc.subjectCreatine Kinase/*blooden
dc.subjectCreatine Kinase, MB Formen
dc.subjectEmergency Treatment/*methods/*standardsen
dc.subjectEvidence-Based Medicineen
dc.subjectHumansen
dc.subjectIsoenzymes/*blooden
dc.subjectMyocardial Infarction/*blood/*diagnosis/enzymologyen
dc.subjectMyocardial Ischemia/*blood/*diagnosis/enzymologyen
dc.subjectMyoglobin/*blooden
dc.subjectReproducibility of Resultsen
dc.subjectResearch Designen
dc.subjectSensitivity and Specificityen
dc.subjectTime Factorsen
dc.subjectTriage/methods/standardsen
dc.subjectTroponin I/*blooden
dc.subjectTroponin T/*blooden
dc.titleAccuracy of biomarkers to diagnose acute cardiac ischemia in the emergency department: a meta-analysisen
heal.typejournalArticle-
heal.type.enJournal articleen
heal.type.elΆρθρο Περιοδικούel
heal.identifier.primary10.1067/mem.2001.114905-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/11326184-
heal.identifier.secondaryhttp://ac.els-cdn.com/S0196064401241080/1-s2.0-S0196064401241080-main.pdf?_tid=881b107f49fe95218e61c76e147d9133&acdnat=1333364612_c4f3516d3ccf9b1455a2555da3d9ad8f-
heal.languageen-
heal.accesscampus-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.publicationDate2001-
heal.abstractSTUDY OBJECTIVE: We sought to evaluate quantitatively the evidence on the diagnostic performance of presentation and serial biochemical markers for emergency department diagnosis of acute cardiac ischemia (ACI), including acute myocardial infarction (AMI) and unstable angina. METHODS: We conducted a systematic review and meta-analysis of the English-language literature published between 1966 and December 1998. We examined the diagnostic performance of creatine kinase, creatine kinase-MB, myoglobin, and troponin I and T testing. Diagnostic performance was assessed by using estimates of test sensitivity and specificity and was summarized by summary receiver-operating characteristic curves. RESULTS: Only 4 studies were found that evaluated all patients with ACI; 73 were found that focused only on a diagnosis of AMI. To diagnose ACI, presentation biomarker tests had sensitivities of 16% to 19% and specificities of 96% to 100%; serial biomarker tests had sensitivities of 31% to 45% and specificities of 95% to 98%. Considering only the diagnosis of AMI, presentation biomarker tests had summary sensitivities of 37% to 49% and summary specificities of 87% to 97%; serial biomarker tests had summary sensitivities of 79% to 93% and summary specificities of 85% to 96%. Variation of test sensitivity was best explained by test timing. Longer symptom duration or time between serial tests yielded higher sensitivity. CONCLUSION: The limited evidence available to evaluate the diagnostic accuracy of biomarkers for ACI suggests that biomarkers have very low sensitivity to diagnose ACI. Thus, biomarkers alone will greatly underdiagnose ACI and will be inadequate to make triage decisions. For AMI diagnosis alone, multiple testing of individual biomarkers over time substantially improves sensitivity, while retaining high specificity, at the expense of additional time. Further high-quality studies are needed on the clinical effect of using biomarkers for patients with ACI in the ED and on optimal timing of serial testing and in combination with other tests.en
heal.journalNameAnn Emerg Meden
heal.journalTypepeer-reviewed-
heal.fullTextAvailabilityTRUE-
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