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Record W2045839505 · doi:10.1373/clinchem.2009.136689

2007 Universal Myocardial Infarction Definition Change Criteria for Risk Stratification by Use of a High-Sensitivity Cardiac Troponin I Assay

2010· letter· en· W2045839505 on OpenAlexafffund
Peter A. Kavsak, Dennis T. Ko, Xuesong Wang, Andrew R. MacRae, Allan S. Jaffe

Bibliographic record

VenueClinical Chemistry · 2010
Typeletter
Languageen
FieldMedicine
TopicAcute Myocardial Infarction Research
Canadian institutionsUniversity of ManitobaUniversity of TorontoJuravinski HospitalMcMaster UniversityInstitute for Clinical Evaluative SciencesHamilton Regional Laboratory Medicine Program
FundersCanadian Institutes of Health Research
KeywordsMedicineMyocardial infarctionTroponin IRisk stratificationAcute coronary syndromeInternal medicineEmergency departmentTroponinChest painCardiologyBiomarkerMyocardial infarction diagnosisAssay sensitivityIntensive care medicinePathology

Abstract

fetched live from OpenAlex

Analytical sensitivity is an important determinant of the diagnostic power of cardiac troponin (cTn)1 for diagnosing myocardial infarction (1)(2). Increased cTn only partially fulfills the criteria to document acute injury, however, because a change (increase/decrease) in biomarker concentration is required (1). A recent study of a contemporary sensitive, guideline-acceptable cTnI assay suggested that change criteria improved risk stratification because it improved the specificity of cTnI in the study for acute coronary syndrome (ACS) (2). Data about the use of change criteria are only beginning to emerge (2). Furthermore, as assay performance improves and more diagnostic companies proceed to develop the second- and third-generation high-sensitivity (hs) assays (3), each must be validated with these criteria. Moreover, there remains no consensus on the criteria to define a changing pattern for cTn assays in clinical use, or for the new hs-cTn assays. One approach has been to use criteria for change obtained from the 2007 universal myocardial infarction (MI) definition (1). This was recently used in a comparison of a sensitive cTnI assay [AccuTnI; refer to Apple (3) for assay designation] against a research third-generation hs assay (hs-cTnI) for early detection of myocardial injury (4). In the present study, we assessed if the criteria for change used in the previous study (4) also add to risk stratification with this hs-cTnI assay. In a cohort of unique subjects (n = 257) presenting with chest pain to an emergency department at a community hospital in 1996, we obtained time of symptom onset, with …

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.005
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Research integrity
Consensus categoriesResearch integrity
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: Commentary
Teacher disagreement score0.296
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0020.005
Meta-epidemiology (narrow)0.0000.001
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0050.007
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.115
GPT teacher head0.373
Teacher spread0.258 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; both teacher heads agree on what is shown here.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations36
Published2010
Admission routes2
Has abstractyes

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