{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T12:18:16Z","timestamp":1773231496582,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["PB\u2010PG\u20101216\u201020034"],"award-info":[{"award-number":["PB\u2010PG\u20101216\u201020034"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the diagnostic accuracy of a novel point of care (POC) high\u2010sensitivity troponin (hs\u2010cTn) assay, used alone or incorporated within validated decision aids, for acute myocardial infarction (AMI) in the prehospital setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pre\u2010specified secondary analysis of the Prehospital Evaluation of Sensitive Troponin (PRESTO) prospective diagnostic accuracy study, conducted in four ambulance services and 12 Emergency Departments (EDs; February 2019\u2013March 2020). Paramedics included consenting adults with suspected AMI and no other reason for conveyance. Clinical data and venous blood were collected at the scene, and samples conveyed to hospital with participants. Plasma samples were later analyzed for hs\u2010cTn using a novel POC hs\u2010cTn assay (Abbott Point of Care i\u2010STAT hs\u2010TnI). The target condition was an adjudicated index diagnosis of type 1 AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 817 consenting participants, 704 were eligible for inclusion in this analysis, with type 1 AMI occurring in 89 (12.6%). At the limit of detection (&lt;\u20092\u2009ng\/L), POC hs\u2010cTn had 100.0% sensitivity (95% CI 95 9%\u2013100.0%) but only 4.6% specificity (95% CI 3.1%\u20136.5%). A Troponin\u2010only Manchester Acute Coronary Syndromes (T\u2010MACS) very\u2010low risk outcome identified 134 (19.7%) patients for non\u2010conveyance with 98.9% sensitivity (95% CI 94.9%\u2013100.0%), 99.3% negative predictive value (NPV, 95% CI 95.0%\u201399.9%), and 22.5% specificity (95% CI 19.2%\u201326.1%). A low\u2010risk modified HEART score identified 150 (22.0%) patients with 93.2% sensitivity (95% CI 85.8%\u201397.5%), 96.0% NPV (91.6%\u201398.1%), and 24.3% specificity (95% CI 20.9%\u201327.9%). In an exploratory analysis, hs\u2010cTn &lt;\u20095\u2009ng\/L identified 295 (41.9%) patients with 98.9% sensitivity (93.9%\u2013100.0%), 99.7% NPV (97.7%\u2013100.0%), and 47.8% specificity (95% CI 43.8%\u201351.8%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This novel POC hs\u2010cTn assay achieves high sensitivity and NPV when used alongside the T\u2010MACS decision aid, but efficiency may be greater at a 5\u2009ng\/L threshold without requiring any decision aid.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT03561051\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70213","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T11:02:23Z","timestamp":1768388543000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Accuracy of a Novel Point of Care High\u2010Sensitivity Troponin Assay in the Prehospital Environment"],"prefix":"10.1111","volume":"33","author":[{"given":"John","family":"Gilman","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine Northern Care Alliance NHS Foundation Trust  Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8292-5212","authenticated-orcid":false,"given":"Abdulrhman","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences  Riyadh Saudi Arabia"},{"name":"King Abdullah International Medical Research Center  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Hann","sequence":"additional","affiliation":[{"name":"Division of Population Health Health Services Research &amp; Primary Care, the University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Carlton","sequence":"additional","affiliation":[{"name":"University of Bristol Medical School, Translational Health Sciences, Southmead Hospital Learning and Research  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie G.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Emergency Department Aberdeen Royal Infirmary, NHS Grampian  Aberdeen UK"},{"name":"School of Medicine, Medical Sciences and Nutrition University of Aberdeen  Aberdeen UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elo\u00efse","family":"Cook","sequence":"additional","affiliation":[{"name":"Emergency Department Manchester University NHS Foundation Trust  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aloysius Niroshan","family":"Siriwardena","sequence":"additional","affiliation":[{"name":"Community and Health Research Unit, School of Health and Social Care, University of Lincoln  Lincoln UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Phillips","sequence":"additional","affiliation":[{"name":"The Ticker Club (A Cardiac Patient Support Group), Wythenshawe Hospital  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4930-5107","authenticated-orcid":false,"given":"Alexander","family":"Thompson","sequence":"additional","affiliation":[{"name":"Division of Population Health Health Services Research &amp; Primary Care, the University of Manchester  Manchester UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3891-6623","authenticated-orcid":false,"given":"Steve","family":"Bell","sequence":"additional","affiliation":[{"name":"Medical Directorate, North West Ambulance Service NHS Foundation Trust  Bolton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Kirby","sequence":"additional","affiliation":[{"name":"Centre for Health and Clinical Research, School of Health and Social Wellbeing, University of the West of England  Bristol UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy","family":"Rosser","sequence":"additional","affiliation":[{"name":"West Midlands Ambulance Service University NHS Foundation Trust  Brierley Hill UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Body","sequence":"additional","affiliation":[{"name":"Emergency Department Manchester University NHS Foundation Trust  Manchester UK"},{"name":"Division of Cardiovascular Science The University of Manchester  Manchester 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