Roehle, Robert and Wieske, Viktoria and Schuetz, Georg M. and Gueret, Pascal and Andreini, Daniele and Meijboom, Willem Bob and Pontone, Gianluca and Garcia, Mario and Alkadhi, Hatem and Honoris, Lily and Hausleiter, Joerg and Bettencourt, Nuno and Zimmermann, Elke and Leschka, Sebastian and Gerber, Bernhard and Rochitte, Carlos and Schoepf, U. Joseph and Shabestari, Abbas Arjmand and Norgaard, Bjarne and Sato, Akira and Knuuti, Juhani and Meijs, Matthijs F. L. and Brodoefel, Harald and Jenkins, Shona M. M. and Ovrehus, Kristian Altern and Diederichsen, Axel Cosmus Pyndt and Hamdan, Ashraf and Halvorsen, Bjorn Arild and Mendoza Rodriguez, Vladimir and Wan, Yung Liang and Rixe, Johannes and Sheikh, Mehraj and Langer, Christoph and Ghostine, Said and Martuscelli, Eugenio and Niinuma, Hiroyuki and Scholte, Arthur and Nikolaou, Konstantin and Ulimoen, Geir and Zhang, Zhaoqi and Mickley, Hans and Nieman, Koen and Kaufmann, Philipp A. and Buechel, Ronny Ralf and Herzog, Bernhard A. and Clouse, Melvin and Halon, David A. and Leipsic, Jonathan and Bush, David and Jakamy, Reda and Sun, Kai and Yang, Lin and Johnson, Thorsten and Laissy, Jean-Pierre and Marcus, Roy and Muraglia, Simone and Tardif, Jean-Claude and Chow, Benjamin and Paul, Narinder and Maintz, David and Hoe, John and de Roos, Albert and Haase, Robert and Laule, Michael and Schlattmann, Peter and Dewey, Marc (2018) Applicability and accuracy of pretest probability calculations implemented in the NICE clinical guideline for decision making about imaging in patients with chest pain of recent onset. EUROPEAN RADIOLOGY, 28 (9). pp. 4006-4017. ISSN 0938-7994, 1432-1084
Full text not available from this repository. (Request a copy)Abstract
To analyse the implementation, applicability and accuracy of the pretest probability calculation provided by NICE clinical guideline 95 for decision making about imaging in patients with chest pain of recent onset. The definitions for pretest probability calculation in the original Duke clinical score and the NICE guideline were compared. We also calculated the agreement and disagreement in pretest probability and the resulting imaging and management groups based on individual patient data from the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT). 4,673 individual patient data from the CoMe-CCT Consortium were analysed. Major differences in definitions in the Duke clinical score and NICE guideline were found for the predictors age and number of risk factors. Pretest probability calculation using guideline criteria was only possible for 30.8 % (1,439/4,673) of patients despite availability of all required data due to ambiguity in guideline definitions for risk factors and age groups. Agreement regarding patient management groups was found in only 70 % (366/523) of patients in whom pretest probability calculation was possible according to both models. Our results suggest that pretest probability calculation for clinical decision making about cardiac imaging as implemented in the NICE clinical guideline for patients has relevant limitations. aEuro cent Duke clinical score is not implemented correctly in NICE guideline 95. aEuro cent Pretest probability assessment in NICE guideline 95 is impossible for most patients. aEuro cent Improved clinical decision making requires accurate pretest probability calculation. aEuro cent These refinements are essential for appropriate use of cardiac CT.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CORONARY-ARTERY-DISEASE; COMPUTED-TOMOGRAPHY; DIAGNOSTIC-ACCURACY; HEART-ASSOCIATION; CALCIUM SCORES; ANGIOGRAPHY; INTERVENTIONS; MANAGEMENT; LIKELIHOOD; COST; Coronary artery disease; Multidetector computed tomography; NICE clinical guideline; Duke clinical score; Pretest probability |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 09 Jan 2020 07:12 |
| Last Modified: | 09 Jan 2020 07:12 |
| URI: | https://pred.uni-regensburg.de/id/eprint/13906 |
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