Faculty Collaboration Database

Test of the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI) for prehospital use. Ann Emerg Med 1996 Feb;27(2):193-8

Date

02/01/1996

Pubmed ID

8629751

DOI

10.1016/s0196-0644(96)70322-0

Scopus ID

2-s2.0-0030063370 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

STUDY OBJECTIVES: To test diagnostic performance for acute cardiac ischemia (ACI) in a manually calculated and in a computerized, ECG-calculated ACI time-insensitive predictive instrument (ACI-TIPI) in prehospital chest pain patients.

METHODS: We carried out prospective inclusion and data acquisition with retrospective analysis. Over a 6-month period, 439 adult emergency medical services patients with chest pain underwent prehospital electrocardiography. Because of incomplete data, 77 cases were excluded, leaving a study sample of 362 patients. Excluded patients did not differ significantly with respect to age, sex, final diagnosis, or history of myocardial infarction, heart surgery, diabetes, or stroke. ACI-TIPI probabilities of ACI were computed on the basis of the prehospital ECGs as interpreted retrospectively and independently by two study investigators blinded to patient outcome, with a specially programmed electrocardiograph, and with a computer algorithm further modified by logistic-regression analysis.

RESULTS: Diagnostic performance on the basis of receiver operating characteristic (ROC) curve areas of the ACI-TIPI was scored, by the two physician readers, .73 and .74; and by ECG, .75. Patients with low ACI-TIPI probability (0% to 9%) had no acute myocardial infarctions, a 2.3% incidence of angina, and no prehospital life-threatening events.

CONCLUSION: ACI-TIPI probabilities of ACI as generated by a specially programmed electrocardiograph are comparable to those based on physician ECG interpretations and may be useful in the prehospital evaluation of chest pain.

Author List

Aufderheide TP, Rowlandson I, Lawrence SW, Kuhn EM, Selker HP

Author

Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acute Disease
Aged
Algorithms
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Ischemia
Predictive Value of Tests
Probability
ROC Curve
Regression Analysis
Retrospective Studies
Signal Processing, Computer-Assisted
Time Factors
Triage