0
Editor's Correspondence |

Electron-Beam Computed Tomography as a Population Screening Tool

Michael Kelleher, MD
Arch Intern Med. 2001;161(21):2624-2625. doi:.
Text Size: A A A
Published online

Extract

In their article, Nallamothu et al1 conclude that, "The performance of EBCT as a diagnostic test for obstructive CAD is reasonable based on sensitivity and specificity rates." Unfortunately, the most common indication for EBCT currently in our market is the screening of asymptomatic adults, often driven by newspaper and billboard advertisements. It would have been helpful for the authors to discuss the implications of their data for such widespread screening of low-risk populations with EBCT. To be specific, if the diagnostic threshold is set to define a sensitivity of 92% and a specificity of 51%, consistent with the studies they summarize, and if the test is applied to a cohort of 1000 asymptomatic adults with a true CAD prevalence of 5% (close to the overall prevalence at age 50 years), the positive predictive power of EBCT will then be only 8.7%. If the sensitivity is reduced to 80%, and the specificity increased to 71%, a compromise that might be suggested for low-risk populations, the positive predictive power increases to only 12.7%. The true values may be lower since the specificity itself can decrease when the test is applied to other populations, eg, older patients with more incidental calcification.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

November 26, 2001
Brahmajee K. Nallamothu, MD, MPH; Sanjay Saint, MD, MPH; Melvyn Rubenfire, MD; A. Mark Fendrick, MD
Arch Intern Med. 2001;161(21):2625. doi:.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles
Jobs
brightcove.createExperiences();