Table 1.

Summary of Diagnostic Accuracy of Findings on Chest Radiograph and Electrocardiogram for AHF in ED Patients Presenting With Dyspnea

Finding	Pooled		Summary LR (95% CI)
	Sensitivity	Specificity	Positive	Negative
Chest radiograph
Pulmonary venous congestion	0.54	0.96	12.0 (6.8–21.0)	0.48 (0.28–0.83)
Interstitial edema	0.34	0.97	12.0 (5.2–27.0)	0.68 (0.54–0.85)
Alveolar edema	0.06	0.99	6.0 (2.2–16.0)	0.95 (0.93–0.97)
Cardiomegaly	0.74	0.78	3.3 (2.4–4.7)	0.33 (0.23–0.48)
Pleural effusion	0.26	0.92	3.2 (2.4–4.3)	0.81 (0.77–0.85)
Any edema	0.70	0.77	3.1 (0.60–16.0)	0.38 (0.11–1.3)
Pneumonia	0.04	0.92	0.50 (0.29–0.87)	1.0 (1.0–1.1)
Hyperinflation	0.03	0.92	0.38 (0.20–0.69)	1.1 (1.0–1.1)
Electrocardiogram
Atrial fibrillation	0.26	0.93	3.8 (1.7–8.8)	0.79 (0.65–0.96)
New T-wave changes	0.24	0.92	3.0 (1.7–5.3)	0.83 (0.74–0.92)
Any abnormal finding	0.50	0.78	2.2 (1.6–3.1)	0.64 (0.47–0.88)
ST elevation	0.05	0.97	1.8 (0.80–4.0)	0.96 (0.95–1.0)
ST depression	0.11	0.94	1.7 (0.97–2.9)	0.95 (0.90–1.0)

AHF = acute heart failure; LR = likelihood ratio.

Adapted from: Wang CS, Fitzgerald JM, Schulzer M, Mak E, Ayas NT. Does this dyspneic patient in the emergency department have congestive HF? JAMA 2005;294:1944–56.¹³