Table 3.

Diagnostic performance of physician assessments in percent (95% CI) for ACS within 30 days

	Sensitivity	Specificity	LR+	LR-
Chest pain history
Typical of ACS	86 (80–91)	80 (77–82)	4.3 (3.8-5.0)	0.2 (0.1-0.3)
Typical of AMI±	47 (38–57)	90 (88–92)	4.9 (3.7-6.5)	0.6 (0.5-0.7)
Typical of UA≠	73 (60–84)	87 (85–89)	5.6 (4.5-7.1)	0.3 (0.2-0.5)
Nonspecific for ACS	13 (8–19)	61 (58–64)	0.3 (0.2-0.5)	1.4 (1.3-1.5)
Not suspicious of ACS	1 (0–4)	59 (56–62)	0.02 (0.00-0.12)	1.7 (1.6-1.8)
ECG
ST-elevation	11 (7–17)	99 (99–100)	15.7 (6.6-37.6)	0.9 (0.8-0.9)
ST-depression	20 (14–27)	98 (97–99)	11.7 (6.6-20.8)	0.8 (0.8-0.9)
T-wave inversion	8 (5–14)	98 (97–98)	3.6 (1.8-7.1)	0.9 (0.9-1.0)
Non-Ischemic*	59 (51–67)	5 (4–6)	0.6 (0.5-0.7)	7.6 (5.5-10.6)
TnT
Positive initial TnT	42 (34–50)	98 (97–99)	(15.0-41.5)	0.7 (0.5- 0.7)
Overall suspicion of ACS
Obvious ACS	12 (7–18)	100 (99–100)	29 (10–86)	0.9 (0.8-0.9)
Strong suspicion	71 (63–77)	85 (83–87)	4.8 (4.0-5.8)	0.4 (0.3-0.4)
Low suspicion	18 (12–25)	59 (56–62)	0.4 (0.3-0.6)	1.4 (1.3-1.5)
No suspicion	0.3 (0.0-3,2)	56 (53–59)	0.01 (0.00-0.12)	1.8 (1.7-1.9)

ACS, Acute coronary syndrome; LR, likelihood ratio; TnT, Troponin T; UA, Unstable angina.

± Calculated with AMI as outcome measure.

≠ Calculated with UA as outcome measure.

*Defined as absence of ST-elevation, ST-depression, T-wave inversion, q-waves and LBBB.