Is this test relevant?
Application to the paper: "Is it possible to exclude a diagnosis of myocardial damage within
six hours of admission to an emergency department?
Diagnostic cohort study"
BMJ 2001;323:372(18 August)
Yes, if you work in an emergency department.
Early diagnosis of MI can lead to worthwhile interventions
such as thrombolysis and treatment of life-threatening arrhythmias
which improve outcomes.
This test may be practical for most ERs but affordability is an issue.
The number of monitored beds, nurses and equipment capable of continuous
ST segment analysis may lead to higher costs.
If the alternative was 24 - 48 hours of inpatient admission, there may actually
be cost savings and patients may be more likely to consent. But what
about the "low risk" patient who perhaps would have been discharged
anyway?