Do Studies of CCTA Overestimate Diagnostic Accuracy?

In a meta-analytical application of the intention-to-diagnose principle, the use of 3×2 tables to deal with nonevaluable results reduced CT's sensitivity and specificity.

Studies comparing coronary computed tomographic angiography (CCTA) with invasive coronary angiography commonly deal with nonevaluable results of the index test either by excluding those segments from the analysis or by treating all nonevaluable segments as either positive or negative. Such approaches can lead to overestimation of diagnostic accuracy in both individual studies and meta-analyses.

To enable an intention-to-diagnose–based meta-analysis of CCTA's diagnostic accuracy, investigators identified 26 studies comparing CCTA with invasive coronary angiography that provided sufficient patient-level data to construct an alternative 3×2 table in addition to the standard 2×2 table used to calculate sensitivity and specificity (see figure).

Th…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)