Assesses likelihood that patient with chest pain and baseline LBBB has myocardial damage. Developed in 1996 by Elena<unk> <unk>  also applies to LBBB due to ventricularly paced rhythm, with more recent reviews demonstrating ~98% specificity when QRS amplitude taken into consideration  
Original<unk>  had low sensitivity(20%), high specificity (98%)
Two main issues suggested for low sensitivity of original rule. First, use of CK (with or without MB) for diagnosis of acute MI, not angiography. Therefore both STEMI & NSTEMI included in acute MI group. Second, anterior STEMI diagnosis limited by<unk>  absolute 5mm ST elevation
Still consider PCI/t-PA for patients with LBBB and "good story" despite not meeting the<unk> 
Previously, a new or presumably new LBBB was indication for emergent reperfusion therapy (i.e. STEMI equivalent)
Guidelines were changed in 2013 due to a high number of false positives
LBBB should now be taken into consideration, but no longer indication for emergent cardiac catheterization
Subsequent Smith Modification improves sensitivity (91%) for a slightly lower specificity (90%), and was validated by Meyers et al in 2015<unk>  also applies to LBBB due to ventricularly paced rhythm, with more recent reviews demonstrating ~98% specificity when QRS amplitude taken into consideration  
Two main issues suggested for low sensitivity of original rule. First, use of CK (with or without MB) for diagnosis of acute MI, not angiography. Therefore both STEMI & NSTEMI included in acute MI group. Second, anterior STEMI diagnosis limited by<unk>  absolute 5mm ST elevation
Still consider PCI/t-PA for patients with LBBB and "good story" despite not meeting the<unk> 
Guidelines were changed in 2013 due to a high number of false positives
LBBB should now be taken into consideration, but no longer indication for emergent cardiac catheterization
Sgarbossa's criteria
Beers criteria
Wells criteria
WES sign
SAD PERSONS score
Faget sign
AVPU scale
ADDIE system