High-Sensitivity Troponin Highlights the Need for New Methods to Evaluate Diagnostic Tests

High-Sensitivity Troponin Highlights the Need for New Methods to Evaluate Diagnostic Tests EDITORIAL High-Sensitivity Troponin Highlights the Need for New Methods to Evaluate Diagnostic Tests See Article by Adamson et al. Jenny Doust, MBBS, PhD Paul Glasziou, MBBS, PhD o be clinically useful, diagnostic tests need high precision. The original tro- ponin assays had poor precision: they had high variability, particularly at the Tlevel used to determine whether a myocardial infarction (MI) was present. To address this problem, high-sensitivity troponin (hs Tn) assays were developed, the sensitivity referring not to the tests’ diagnostic sensitivity, but the analytic sensitivity with lower limits of detection and greater precision, including at the upper refer- ence limit used to determine the presence of MI. This makes hs Tn more useful for ruling out MI and acute coronary syndrome in patients presenting with acute chest pain, allowing a greater proportion of patients to be discharged home earlier and potentially reducing the sex bias in the diagnosis of MI. These assays have been in use in Europe and Australasia since about 2010 but have only recently been ap- proved by the Food and Drug Administration for clinical use in the United States. The study by Adamson et al in this issue of Circulation: Cardiovascular Quality and Outcomes http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation: Cardiovascular Quality & Outcomes Wolters Kluwer Health

High-Sensitivity Troponin Highlights the Need for New Methods to Evaluate Diagnostic Tests

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Publisher
Wolters Kluwer Health
Copyright
© 2018 American Heart Association, Inc.
ISSN
1941-7705
eISSN
1941-7713
D.O.I.
10.1161/CIRCOUTCOMES.117.004468
Publisher site
See Article on Publisher Site

Abstract

EDITORIAL High-Sensitivity Troponin Highlights the Need for New Methods to Evaluate Diagnostic Tests See Article by Adamson et al. Jenny Doust, MBBS, PhD Paul Glasziou, MBBS, PhD o be clinically useful, diagnostic tests need high precision. The original tro- ponin assays had poor precision: they had high variability, particularly at the Tlevel used to determine whether a myocardial infarction (MI) was present. To address this problem, high-sensitivity troponin (hs Tn) assays were developed, the sensitivity referring not to the tests’ diagnostic sensitivity, but the analytic sensitivity with lower limits of detection and greater precision, including at the upper refer- ence limit used to determine the presence of MI. This makes hs Tn more useful for ruling out MI and acute coronary syndrome in patients presenting with acute chest pain, allowing a greater proportion of patients to be discharged home earlier and potentially reducing the sex bias in the diagnosis of MI. These assays have been in use in Europe and Australasia since about 2010 but have only recently been ap- proved by the Food and Drug Administration for clinical use in the United States. The study by Adamson et al in this issue of Circulation: Cardiovascular Quality and Outcomes

Journal

Circulation: Cardiovascular Quality & OutcomesWolters Kluwer Health

Published: Feb 1, 2018

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