March 1, 1985Circulation
Alternative diagnostic strategies for coronary artery disease in women: demonstration of the usefulness and efficiency of probability analysis.
Key result
Diagnostic strategies using conditional probability analysis with selective thallium scintigraphy accurately predicted coronary disease (p<0.05) and could avoid half of diagnostic catheterizations.
Why the study?
Does a conditional probability analysis strategy improve the efficiency and accuracy of diagnosing coronary artery disease in women presenting with chest pain?
Population
135 women presenting with chest pain (93 infarct-free women and 42 consecutive female patients)
Comparison
Four hypothetical diagnostic strategies using a… vs Coronary angiogram as the standard reference
Design
Cohort
Authors
Discussion
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Implication
May reduce unnecessary catheterizations in women with chest pain; leaves open need for randomized validation of accuracy.
Study Design
Type
Observational (n=135)
Structured PICO
Does a conditional probability analysis strategy improve the efficiency and accuracy of diagnosing coronary artery disease in women presenting with chest pain?
P
Population
135 infarct-free women presenting with chest pain evaluated with stress electrocardiography, thallium scintigraphy, and coronary angiography.
E
Exposure
Four hypothetical diagnostic strategies (S0, S1, S2, S3) using a computerized Bayesian algorithm to calculate pretest and posttest probabilities of coronary artery disease based on history, stress electrocardiography, and stress thallium scintigraphy
C
Comparator
Coronary angiogram as the standard reference
O
Outcome
Accuracy in predicting the presence or absence of coronary diseasesurrogate
Main Result
p-value: p=<0.05
A sequential diagnostic strategy using conditional probability analysis can accurately diagnose coronary artery disease in women while significantly reducing the need for unnecessary scintigraphy and invasive catheterization.
Cite This Study
Wijns et al. (1985) conducted an observational in Coronary artery disease (n=135). Conditional probability analysis strategies (S0-S3) vs. Coronary angiogram was evaluated on Accuracy in predicting the presence or absence of coronary disease (p=<0.05). Diagnostic strategies using conditional probability analysis with selective thallium scintigraphy accurately predicted coronary disease (p<0.05) and could avoid half of diagnostic catheterizations.