Influence of coronary artery disease prevalence on predictive values of coronary CT angiography: a meta-regression analysis
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Peter Schlattmann & Georg M. Schuetz & Marc Dewey
- چاپ و سال / کشور: 2011
Description
Objective To evaluate the impact of coronary artery disease (CAD) prevalence on the predictive values of coronary CT angiography. Methods We performed a meta-regression based on a generalised linear mixed model using the binomial distribution and a logit link to analyse the influence of the prevalence of CAD in published studies on the per-patient negative and positive predictive values of CT in comparison to conventional coronary angiography as the reference standard. A prevalence range in which the negative predictive value was higher than 90%, while at the same time the positive predictive value was higher than 70%was considered appropriate. Results The summary negative and positive predictive values of coronary CT angiography were 93.7% (95% confidence interval [CI] 92.8.94.5%) and 87.5% (95% CI, 86.5.88.5%), respectively. With 95% confidence, negative and positive predictive values higher than 90% and 70% were available with CT for a CAD prevalence of 18.63%. CT systems with >16 detector rows met these requirements for the positive (P<0.01) and negative (P<0.05) predictive values in a significantly broader range than systems with .16 detector rows. Conclusion It is reasonable to perform coronary CT angiography as a rule-out test in patients with a low-tointermediate likelihood of disease.
Eur Radiol (2011) 21:1904–1913 DOI 10.1007/s00330-011-2142-2 Received: 30 December 2010 / Revised: 9 March 2011 / Accepted: 11 March 2011 / Published online: 20 May 2011
