Alan M. Garber, MD; Neil A. Solomon, MD
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Garber A., Solomon N.; Tests for Coronary Artery Disease. Ann Intern Med. 1999;131:980. doi: 10.7326/0003-4819-131-12-199912210-00018
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Published: Ann Intern Med. 1999;131(12):980.
Our study grew from an effort to compare commonly used noninvasive tests and a less commonly used, but highly accurate, alternative (positron emission tomography). We did not include electron-beam computed tomography (CT) in the comparison because it was not a widely accepted diagnostic test for coronary disease. The analysis considered stress echocardiography but not intravascular ultrasonography, which is usually performed as part of cardiac catheterization. To compare electron-beam CT with the other tests, the accuracy of electron-beam CT must be estimated from a pooled analysis of available studies, using inclusion and exclusion criteria such as those we used for the other noninvasive tests. Judging accuracy from a single study could be highly misleading because the published accuracy figures for electron-beam CT vary widely. Thus, we believe that it would be inappropriate to draw conclusions about the cost-effectiveness of electron-beam CT without conducting the pooled analysis. However, the growing number of studies assessing the accuracy of electron-beam CT in the diagnosis of coronary disease makes the comparison that Drs. Broemeling and Mielke suggest both timely and relevant.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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