Critical analysis of the application of Bayes theorem to sequential testing in the noninvasive diagnosis of coronary artery disease
The utility of Bayes theorem in the noninvasive diagnosis of coronary artery disease (CAD) was analyzed in 147 patients who underwent electrocardiographic stress testing, thallium-201 perfusion imaging and coronary angiography. Eighty-nine patients had typical anginal chest discomfort and 58 had atypical chest pain. Sensitivity and specificity of the tests and prevalence of CAD at each level of testing were tabulated and compared with the results generated from Bayes theorem. The sensitivity of electrocardiographic stress was higher in patients with multivessel CAD than in patients with 1-vessel CAD. Sensitivity, but not specificity, of each test was dependent, in part, on the result of the other test. However, the probabilities calculated from Bayes theorem when used for sequential testing are remarkably close to the tabulated data. Thus, Bayes theorem is useful clinically despite some evidence of test dependence. Sequential test analysis by Bayes theorem is most useful in establishing or ruling out a diagnosis when the pretest prevalence is approximately 50% and when the 2 tests are concordant.
- Research Organization:
- Presbyterian Univ. of Pennsylvania Medical Center, Philadelphia
- OSTI ID:
- 6349557
- Journal Information:
- Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 54:1; ISSN AJCDA
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
550602 -- Medicine-- External Radiation in Diagnostics-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
ARTERIES
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
CORONARIES
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PROBABILITY
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
VASCULAR DISEASES