How well do MACS, T-MACS and HE-MACS perform in emergency department patients with suspected cardiac chest pain? This appraisal examines a systematic review of their diagnostic accuracy, differences between study populations and the importance of external validation, while acknowledging the St Emlyn’s team’s involvement in developing the scores.
Systematic review of the Manchester Acute Coronary Scores. Read More
A 2021 appraisal of early CT coronary angiography for patients with suspected acute coronary syndrome. It examines a UK randomised trial’s patient outcomes, use of invasive angiography and limitations, asking whether routine CTCA is justified in this selected population.
JC: CTCA for cardiac chest pain in the ED. St Emlyn’s Read More
Can an undetectable high-sensitivity troponin, a non-ischaemic ECG and clinical assessment speed safe discharge for chest pain? This 2020 LoDED trial appraisal examines its inconclusive primary comparison, variation in usual care and the limits of the safety data, keeping clinical judgement central.
JC: Are we fully LoDED? Read More
Ashley Liebig’s January 2020 introduction to the novel coronavirus outbreak, written as cases began appearing beyond China. The article records the early questions facing clinicians and the information available at that point, offering a historical snapshot rather than an up-to-date account of COVID-19.
2019 Novel Coronavirus (Wuhan) at St Emlyn’s Read More
Rick Body looks back at a decade of change in emergency diagnostics, from high-sensitivity troponin to decision aids and more individualised estimates of risk. Written as 2020 began, the review also considers where artificial intelligence, point-of-care testing and remote healthcare might take the next decade.
A Decade of Diagnostics in Emergency Care Read More
How do T-MACS, HEART, TIMI and EDACS compare with a troponin-only strategy for suspected cardiac chest pain? This review examines a multicentre study using one high-sensitivity troponin I assay, balancing diagnostic sensitivity and rule-out efficiency against missing data and limits to generalisability.
Risk scores for cardiac chest pain: the first head-to-head comparison! Read More
How should we assess and reduce venous thromboembolism risk after lower-limb immobilisation? Dan Horner reviews the 2019 TiLLI project, examining thromboprophylaxis evidence, risk assessment tools and cost-effectiveness, while highlighting uncertainty about which patients benefit and how to communicate that risk.
Thromboprophylaxis in Lower Limb Immobilisation #RCEMASC2019 Read More
Dan Horner reviews outpatient pulmonary embolism care in this article supporting his 2019 RCEM CPD talk. It examines patient selection, follow-up and British Thoracic Society guidance, alongside conflicting evidence about investigating suspected pulmonary embolism in pregnancy.
JC: Pulmonary embolism, ambulatory care and the goddess of the hunt Read More
