Abstract
This review presents a brief overview of existing diagnostic and prognostic methodologies to be used for the evaluation of patients undergoing noninvasive testing. In part I of this review, we will present methods for use of logistic and Cox regression analyses in determining the diagnostic and prognostic value of nuclear imaging techniques. In part II of this review, we will present an outline for the integration of economic evaluations into the clinical decision-making process. This review will document how cost estimates may be defined as well as the differing type of cost analyses (i.e., cost efficiency versus cost-effectiveness).
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Christian TF, Miller TD, Bailey KR, Gibbons RJ. Exercise tomographic thallium-201 imaging in patients with severe coronary artery disease and normal electrocardiograms. Ann Intern Med 1994;121:825–32.
Silver MT, Rose GA, Paul SD, Odonnell CJ, O’Gara PT, Eagle KA. A clinical rule to predict preserved left ventricular ejection fraction in patients after myocardial infarction. Ann Intern Med 1994;121:750–6.
Rozanski A, Diamond GA, Berman D, Forrester JS, Morris D, Swan HJ. The declining specificity of exercise radionuclide ventriculography. N Engl J Med 1983;309:518–22.
Shaw LJ, Chaitman BR, Hilton TC, Stocke K, Younis LT, Kong BA, et al. Prognostic value of dipyridamole thallium-201 imaging in elderly patients. J Am Coll Cardiol 1992;19:1390–8.
Jaeschke R, Guyatt GH, Sackett DL, for the Evidence-Based Medicine Working Group. Users’ guides to the medical literature. JAMA 1994;271:703–8.
Hachamovitch R, Berman DS, Kiat H, Bairey-Merz N, Cohen I, Cabico JA, et al. Gender-related differences in clinical management after exercise nuclear testing. J Am Coll Cardiol 1995;26: 1457–64.
Pryor DB, Shaw L, Harrell FE Jr, Lee KL, Hlatky MA, Mark DB, et al. Estimating the likelihood of severe coronary artery disease. Am J Med 1991;90:553–62.
Miller DD, Heller GV, Travin MI, Kesler KL, Delong ER, Eisenstein E, et al. for the Economic Study of Noninvasive Diagnosis (END) Multicenter Study Group. A multicenter study of 2737 patients examining the multivariable prognostic value of stress single photon emission computed tomography (SPECT) myocardial perfusion scintigraphy [abstract]. J Am Coll Cardiol 1996;27:286A.
Shaw LJ, Peterson ED, Kesler K, Hasselblad V, Califf RM. A meta-analysis of predischarge risk stratification after acute myocardial infarction with stress electrocardiographic, myocardial perfusion, and ventricular function imaging. Am J Cardiol In press.
Lee KL, Pryor DB, Pieper KS, Harrell FE Jr, Califf RM, Mark DB, et al. The prognostic value of radionuclide angiography in medically treated patients with coronary artery disease: a comparison with clinical and catheterization variables. Circulation 1990;82:1705–17.
Kesler K, Shaw LJ, Heinle SK, Borges-Neto S, Jones RH, for the Duke Noninvasive Research Working Group. Prognosis in patients with coronary artery disease by equilibrium radionuclide measurements of left ventricular function during exercise. J Am Coll Cardiol 1996;27:286A.
Yusuf S, Zucker D, Peduzzi P, Fisher LD, et al. Effect of coronary artery bypass surgery on survival: overview of 10-year results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet 1994;344:563–70.
King SB III, Lembo NJ, Weintraub WAS, Kosinski AS, Barnhart HX, Kutner MH, et al. A randomized trial comparing coronary angioplasty with coronary bypass surgery. N Engl J Med 1994; 331:1044–50.
Mark DB, Nelson CL, Califf RM, Harrell FE Jr, Lee KL, Jones RH, et al. Continuing evolution of therapy for coronary artery disease. Circulation 1994;89:2015–25.
Califf RM, Ohman EM. The diagnosis of acute myocardial infarction. Chest 1992;101:106S-15S.
Harrell FE, Lee KL, Mark DB. Multivariable prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med 1996;15: 361–87.
Feinstein AR, Wells CK, Walter SD. A comparison of multivariable methods for predicting survival, 1: introduction, rationale, and general strategy. J Clin Epidemiol 1990;43:339–47.
Walter SD, Feinstein AR, Wells CK. A comparison of multivariable mathematical methods for predicting survival. J Clin Epidemiol 1990;43:349–59.
Shaw LK, DeLong ER, Peterson ED, Jollis JG, Collins R, Mark DB. Leveling the playing field in outcomes comparisons: patient versus medical record data [abstract]. J Am Coll Cardiol 1996;27: 245A.
Pryor DB, Harrell FE Jr, Lee KL, Califf RM, Rosati RA. Estimating the likelihood of significant coronary artery disease. Am J Med 1983;75:771–80.
Pryor DB, Shaw L, McCants CB, Lee KL, Mark DB, Harrell FE Jr, et al. Value of the history and physical in identifying patients at increased fisk for coronary artery disease. Ann Intern Med 1993;118:81–90.
Hachamovitch R, Berman DS, Kiat H, Cohen I, Cabico JA, Friedman J, et al. Exercise myocardial perfusion SPECT in patients without known coronary artery disease. Circulation 1996; 93:905–14.
Shaw LJ, Miller DD, Romeis JC, Kargl D, Younis LT, Chaitman BR. Gender differences in the noninvasive evaluation and management of patients with suspected coronary artery disease. Ann Intern Med 1994;120:559–66.
Shaw LJ, Kesler K, Peterson ED, Harrell FE, Shaw LK, DeLong ER, et al. The Duke treadmill score is an accurate predictor of the extent of coronary artery disease and 5-year survival. Circulation 1995;92:I-271.
Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristics (ROC) curve. Radiology 1982; 143:29–36.
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Part II will appear in Vol. 4, No. 1.
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Shaw, L.J., Hachamovitch, R., Eisenstein, E.L. et al. A primer of biostatistic and economic methods for diagnostic and prognostic modeling in nuclear cardiology: Part I. J Nucl Cardiol 3, 538–545 (1996). https://doi.org/10.1016/S1071-3581(96)90062-8
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DOI: https://doi.org/10.1016/S1071-3581(96)90062-8