Table 6Positive and negative likelihood ratios for individual components of the clinical history and signs and symptoms for the assessment of acute chest pain

SymptomNumber of studiesLR95%CIP for heterogeneity
Pleuritic painPLR30.190.14 to 0.250.5
NLR1.171.15 to 1.190.003
Sharp painPLR20.320.21 to 0.500.3
NLR1.361.26 to 1.460.4
Positional painPLR20.270.21 to 0.360.3
NLR1.121.11 to 1.140.09
Pain on palpationPLR30.230.08 to 0.300.15
NLR1.181.16 to 1.200.001
Crushing painPLR61.441.39 to 1.490.14
NLR0.630.60 to 0.670.9
Central painPLR31.241.2 to 1.270.01
NLR0.490.43 to 1.560.002
Left-sided radiation of painPLR21.451.36 to 1.550.004
NLR0.780.73 to 0.820.02
Right-sided radiation of painPLR22.591.85 to 3.700.7
NLR0.80.72 to 0.880.01
Any radiation of painPLR21.431.33 to 1.550.7
NLR0.80.75 to 0.840.01
Pain duration > 1 hPLR11.31.15 to 1.47only one study
NLR0.350.19 to 0.64
Previous MI/anginaPLR41.291.22 to 1.360.001
NLR0.840.81 to 0.880.001
Nausea/vomitingPLR41.881.58 to 2.230.5
NLR0.770.71 to 0.840.001
SweatingPLR52.061.96 to 2.160.7
NLR0.650.62 to 0.670.001
Pulmonary cracklesPLR12.081.42 to 3.05only 1 study
NLR0.760.62 to 0.93
Systolic blood pressure < 80 mmHgPLR13.061.80 to 5.22only 1 study
NLR0.970.95 to 0.99

PLR = positive likelihood ratio, NLR = negative likelihood ratio.

Permissions granted from original source (Mant, J., McManus, R. J., Oakes, R.-A. L. et al, 2004).

From: 4, People Presenting with Acute Chest Pain Chapter

Cover of Chest Pain of Recent Onset
Chest Pain of Recent Onset: Assessment and Diagnosis of Recent Onset Chest Pain or Discomfort of Suspected Cardiac Origin [Internet].
NICE Clinical Guidelines, No. 95.
National Clinical Guideline Centre for Acute and Chronic Conditions (UK).
Copyright © 2010, National Clinical Guideline Centre for Acute and Chronic Conditions.

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