Prediction models as gatekeepers for diagnostic testing in angina patients with suspected chronic coronary syndrome
Research output: Contribution to journal › Journal article › Research › peer-review
Aims Assessment of pre-test probability (PTP) is an important gatekeeper when selecting patients for diagnostic testing for coronary artery disease (CAD). The 2019 European Society of Cardiology (ESC) guidelines recommend upgrading PTP based on clinical risk factors but provide no estimates of how these affect PTP. We aimed to validate two published PTP models in a contemporary low-CAD-prevalence cohort and compare with the ESC 2019 PTP. Methods and results Previously published basic and clinical prediction models and the ESC 2019 PTP were validated in 42 328 patients (54% women) >= 30 years old without previous CAD referred for cardiac computed tomography angiography in a region of Denmark from 2008 to 2017. Obstructive CAD prevalence was 8.8%. The ESC 2019 PTP and basic model included angina symptoms, sex, and age, while the clinical model added diabetes mellitus family history of CAD, and dyslipidaemia. Discrimination was good for all three models [area under the receiver operating curve (AUC) 0.76, 95% confidence interval (CI) (0.75-0.77), 0.74 (0.73-0.75), and 0.76 (0.75-0.76), respectively]. Using the clinically relevant low predicted probability
Original language | English |
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Journal | European Heart Journal - Quality of Care and Clinical Outcomes |
Volume | 8 |
Issue number | 6 |
Pages (from-to) | 630-639 |
Number of pages | 10 |
ISSN | 2058-5225 |
DOIs | |
Publication status | Published - 2022 |
- Pre-test probability, Risk stratification, Prediction model, Chronic coronary syndrome, External validation, ARTERY CALCIUM, ESC GUIDELINES, PROBABILITY, VALIDATION, MANAGEMENT, OUTCOMES, PROMISE, SOCIETY, CURVE
Research areas
ID: 328443488