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Table 1 input parameters concerning patient pathways used in the model

From: The cost-utility of point-of-care troponin testing to diagnose acute coronary syndrome in primary care

Parameter

Category

Probability

95% CI

Distribution

Reference

Perceived probability of ACS by GP

High probability

14.7%

8.2% to 22.5%

Beta

[15]

ECG

Performed at GP’s office

57.4%

56.0% to 58.7%

Beta

[16]

Sensitivity for STEMI

50.0%

37.6% to 62.6%

Beta

[17]

Time from symptom onset to presentation (male)

< 4 h

47.5%

38.9% to 55.4%

Dirichlet

[19, 40]

4–5.5 h

9.0%

5.2% to 14.5%

Dirichlet

[19, 40]

5.5–7 h

7.3%

3.4% to 11.8%

Dirichlet

[19, 40]

7–10 h

9.4%

5.2% to 14.9%

Dirichlet

[19, 40]

> 10 h

26.8%

20.0% to 34.6%

Dirichlet

[19, 40]

Time from symptom onset to presentation (female)

< 4 h

54.8%

47.1% to 62.7%

Dirichlet

[19, 40]

4–5.5 h

9.4%

5.1% to 13.9%

Dirichlet

[19, 40]

5.5–7 h

6.5%

3.1% to 10.7%

Dirichlet

[19, 40]

7–10 h

8.0%

4.6% to 13.1%

Dirichlet

[19, 40]

> 10 h

21.2%

15.2% to 27.8%

Dirichlet

[19, 40]

Diagnostic performance of GP, without POC troponin

Sensitivity

88.3%

79.2% to 95.2%

Beta

[18]

Specificity

72.2%

67.9% to 76.3%

Beta

[18]

Sensitivity of POC troponin at different duration of symptoms

4–5.5 h

66.7%

55.5% to 77.0%

Beta

[7]

5.5–7 h

79.2%

69.3% to 87.5%

Beta

[7]

7–10 h

84.7%

75.3% to 91.9%

Beta

[7]

> 10 h

87.5%

78.8% to 94.2%

Beta

[7]

Specificity of POC troponin at different duration of symptoms

4–5.5 h

95.9%

94.2% to 97.3%

Beta

[7]

5.5–7 h

94.4%

92.5% to 96.1%

Beta

[7]

7–10 h

93.4%

91.3% to 95.3%

Beta

[7]

> 10 h

92.6%

90.4% to 94.5%

Beta

[7]

Revise referral decision after discordant POC troponin

Negative troponin

80.6%

73.3% to 87.1%

Beta

[15]

Positive troponin

83.3%

76.3% to 89.3%

Beta

[15]

  1. This table shows the parameter, the value used in the model, the 95% confidence interval, the distribution used, and the data source. ACS acute coronary syndrome, CI confidence interval, ECG electrocardiogram, GP general practitioner, POC point-of-care, STEMI ST elevation myocardial infarction