Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
Copyright 1999 American Medical Association.
All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.1999
In Reply: We thank Dr Kao for his
thoughtful comments and agree that the ECG, and specifically the
presence of new ST-segment elevation and new Q waves, plays an
important role in aiding the diagnosis of MI. In particular in our
review we found that the presence of a new ST-segment elevation was
associated with likelihood ratios of 5.7 to 53.9, while the presence of
any ST-segment elevation (which by definition includes ST-segment
elevation that may have been present on a prior ECG) was associated
with a likelihood ratio of only 11.2. Similarly, new Q waves, as
opposed to any Q waves, also were associated with higher likelihood
ratios and therefore more likely to occur in patients with, as opposed
to those without, MI.
Panju AA, Hemmelgarn BR. Children. JAMA. 1999;281(8):705. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-8-jbk0224