Lack of concordance between a rapid bedside and conventional laboratory method of cardiac troponin testing: Impact on risk stratification of patients suspected of acute coronary syndrome

“…Previously there have been concerns that POC cTn assays lack the analytical sensitivity of laboratory assays, have higher levels of imprecision, lack of concordance with laboratory assays, and variability between assays that results in an overall lower clinical sensitivity for AMI [11][12][13][14][15][16]. This means that older POC assays carried the disadvantage that a higher proportion of patients with AMI were not detected, either overall or in the early period after onset of symptoms.…”

Section: Discussionmentioning

confidence: 91%

“…Previous studies have shown laboratory result turn-around times of 65-128 min and POC turnaround times of 15-26.5 min [17][18][19][20][21]. Recommendations for turnaround times by the American College of Cardiology/American Heart Association and National Academy for Clinical Biochemistry for core laboratories suggest a maximum of 60 min and recommend that if this is not achievable, POC devices should be used [11,13,17]. Shorter turnaround times can potentially accelerate clinical decision making and patient discharge (in those with negative results) which may reduce ED and hospital overcrowding and have economical benefits; and possibly acceleration of treatment pathways (in those with positive results) which may improve outcomes, although a not insignificant false positive rate should alert physicians to employ clinical judgment in these patients.…”

Section: Discussionmentioning

confidence: 96%

Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction

Aldous

Richards

George

et al. 2014

International Journal of Cardiology

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“…High sensitivity45 POC cardiac troponin biomarker testing can enhance cardiology services wherever specialists and trained local physicians are located, as both groups can provide crucial immediate treatment of appropriate targeted regimens [for STEMI and NSTEMI46] once the diagnosis is documented, working either locally in emergency rooms or via telemedicine to improve cost-effectiveness and patient outcomes in the regional system of small-world networks.…”

Section: Discussionmentioning

confidence: 99%

Emergency Cardiac Biomarkers and Point-of-Care Testing

Kost¹,

Kost²,

Suwanyangyuen³

et al. 2010

Point of Care: The Journal of Near-Patient Testing &Amp; Technology

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IntroductionThe goals of this paper are a) to facilitate the efficient diagnosis of patients who present with episodes of acute chest pain in rural emergency rooms located in low-resource community hospitals, b) to systematically optimize point-of-care (POC) testing using small-world networks (SWNs) adapted to unique and challenging geographic settings, and c) to align POC cardiac biomaker testing with referral options and treatment modalities available to local emergency medicine nurses and physicians. Methods Field SurveysField surveys focused primarily on a) cardiac biomarker testing and related cardiology and emergency medical system (EMS) services (Figure 1), b) point-of-care testing (POCT) resources and competency levels, and c) healthcare delivery systems within and between provinces in Isaan, northeastern Thailand. We visited and surveyed on site 3 referral hospitals Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. in Khon Kaen City, 5 province regional hospitals (RHs), and 10 community hospitals (CHs) administered by the Thai government in 6 provinces (Tables 1 and 2). NIH Public Access Response RateThe research process was developed carefully during prior field surveys in Sakaeo Province as part of Fulbright-sponsored research 1-3 and subsequently improved for several other regions of Thailand 4 and the United States 5 . Most POCT and clinical laboratory equipment was photo documented. Live interviews and telephone follow-up yielded a 100% return rate on survey questions, which included needs assessment. On-Site InterviewsInterviews were conducted in the Thai language. At each site a defined list of questions ("short form") was used to structure data gathered for consistency during discussions with hospital administrators, clinical directors, physicians, nurses, EMS personnel, ambulance drivers, laboratory technologists, and other staff in CHs and RHs. Additionally, we investigated Primary Care Units (PCUs) in follow-up. DemographyFrom on-site interviews, we collected health demography facts about each medical site, such as the number of hospital beds, numbers and types of physicians, the status of critical care units (e.g., ICU, CCU, OR, and ER), and the impact of patients with acute coronary syndrome (ACS) and acute myocardial infarction (AMI) on emergency services. National databases were consulted for population and health resources data 6-8.Province populations, PCUs, beds, physicians, professional nurses, technical nurses, and pharmacists were 977508, 157, 1105, 104, 898, 155, and 73 for Kalasin; 1752414, 146, 3748, 540, 2915, 454, and 212 for Khon Kaen; 9...

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Lack of concordance between a rapid bedside and conventional laboratory method of cardiac troponin testing: Impact on risk stratification of patients suspected of acute coronary syndrome

Cited by 11 publications

References 11 publications

Point of care troponin decreases time in the emergency department for patients with possible acute coronary syndrome: a randomised controlled trial

Point of care troponin decreases time in the emergency department for patients with possible acute coronary syndrome: a randomised controlled trial

Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction

Emergency Cardiac Biomarkers and Point-of-Care Testing

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