{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T23:42:09Z","timestamp":1782949329546,"version":"3.54.5"},"reference-count":0,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2003,3,1]],"date-time":"2003-03-01T00:00:00Z","timestamp":1046476800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Clin Biochem"],"published-print":{"date-parts":[[2003,3,1]]},"abstract":"<jats:p>Background: Assessment of the relative diagnostic accuracy of investigation strategies for patients with suspected acute coronary syndromes (ACS).<\/jats:p>\n                  <jats:p>Methods: A prospective observational study followed two groups of patients over a 3-month period in a UK district general hospital. Group one: all admissions with suspected ACS ( n = 576); group two: non-cardiac in-patients who were suspected of developing ACS ( n = 87). Both were investigated by full clinical history, examination and serial electrocardiographs (ECGs). Conventional World Health Organization (WHO) criteria for myocardial damage were compared with diagnosis based on cardiac troponin T (cTnT). Clinical discharge diagnosis based on conventional WHO criteria was compared with the review diagnosis based on measurement of cTnT.<\/jats:p>\n                  <jats:p>Results: Diagnosis based on WHO criteria missed 58 patients (8\u00b77%) admitted with suspected ACS who had high risk unstable angina. Thirty-three patients (5% of all admissions) who were diagnosed as non-Q wave acute myocardial infarction (AMI) were found to have normal troponin values and to have been incorrectly classified as AMI.<\/jats:p>\n                  <jats:p>Conclusions: Diagnostic strategies based on WHO criteria are inaccurate. The measurement of cTnT in all patients with suspected ACS would have increased the number of those with a diagnosis of AMI by 58 (8\u00b77%), while avoiding inaccurate diagnosis in 33 (5%), therefore producing an absolute increase of 25\/663 (3\u00b78%) but a relative increase of 58\/138 (42%). In patients with a primary diagnosis of suspected ACS, the overall increase in patients with a diagnosis of AMI will be 55 (9\u00b75%), a relative increase of 55\/118 (46\u00b76%) but an absolute increase of 36\/576 (6\u00b73%).<\/jats:p>","DOI":"10.1258\/000456303763046085","type":"journal-article","created":{"date-parts":[[2003,3,27]],"date-time":"2003-03-27T18:45:33Z","timestamp":1048790733000},"page":"156-160","source":"Crossref","is-referenced-by-count":17,"title":["Impact of European Society of Cardiology\/American College of Cardiology                guidelines on diagnostic classification of patients with suspected acute coronary                syndromes"],"prefix":"10.1177","volume":"40","author":[{"given":"P. O.","family":"Collinson","sequence":"first","affiliation":[{"name":"Departments of Chemical Pathology and Cardiology, Mayday University\r                  Hospital, Thornton Heath, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. C.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Canepa-Anson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2003,3,1]]},"container-title":["Annals of Clinical Biochemistry: International Journal of Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/000456303763046085","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1258\/000456303763046085","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:52:35Z","timestamp":1777377155000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1258\/000456303763046085"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,3,1]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2003,3,1]]}},"alternative-id":["10.1258\/000456303763046085"],"URL":"https:\/\/doi.org\/10.1258\/000456303763046085","relation":{},"ISSN":["0004-5632","1758-1001"],"issn-type":[{"value":"0004-5632","type":"print"},{"value":"1758-1001","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,3,1]]}}}