A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension
Why the study?
Does an updated clinical prediction rule improve the estimation of coronary artery disease probability compared to the original Diamond-Forrester model?
Population
Patients evaluated for coronary artery disease, including women and patients 70 years and older
Comparison
Updated clinical prediction rule vs Original Diamond-Forrester model
Design
Cohort
Authors
Discussion
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Member takes
Implication
May refine CAD pretest probability estimates in women and older adults; leaves open prospective validation before practice change.
Structured PICO
Does an updated clinical prediction rule improve the estimation of coronary artery disease probability compared to the original Diamond-Forrester model?
P
Population
Patients evaluated for coronary artery disease, including women and patients 70 years and older
I
Intervention
Updated clinical prediction rule (incorporating age, sex, type of chest pain, and hospital setting)
C
Comparator
Original Diamond-Forrester model
O
Outcome
Probability of coronary artery disease (model performance)
An updated clinical prediction rule improves upon the Diamond-Forrester model for diagnosing CAD, particularly by addressing overestimation in women and extending applicability to older patients.
Cite This Study
Genders et al. (2011) studied this question.