Bayesian analysis using Fourier transforms of thallium-201 scintiscans to predict the presence of coronary artery disease
Bayes' theorem of conditional probability was applied to the diagnosis of coronary artery disease (CAD) using thallium-201 scintigraphy as the testing procedure. Thallium-201 scintiscans were evaluated with a discriminant function previously developed using the amplitude coefficients of the Fourier transforms of the scans. The technique was applied prospectively to a population of 100 patients undergoing diagnostic coronary arteriography and thallium-201 scintigraphy, including 83 patients with CAD (70% or greater stenosis of luminal diameter) and 17 control subjects. A pretest probability of CAD was determined for each patient from the patient's age, sex and anginal symptoms. The pretest probability was combined with the patient's discriminant score to determine a post-test probability for CAD. For patients with CAD, the mean post-test probability was 0.85. Moreover, 57 of 83 patients (69%) had post-test probabilities exceeding 90%, including 40 patients (48%) with post-test probabilities exceeding 99%. For control subjects, the mean post-test probability was 0.19, with 11 of 17 (65%) having a post-test probability of less than 10%. Overall, 68 subjects had a post-test probability either less than 10% or more than 90% of which 63 were correctly classified (93%). Using a 50% post-test probability as a cutoff for classification, the technique has an 89% sensitivity, an 82% specificity and an overall accuracy of 88%. Therefore, this method objectively distinguishes patients with CAD from control subjects and provides a measure of the certainty of diagnosis. In addition, the discriminant function avoids the problem of inter- and intraobserver variability in visually interpreting thallium-201 scans.
- Research Organization:
- Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York
- OSTI ID:
- 6480596
- Journal Information:
- Am. J. Cardiol.; (United States), Vol. 54:3
- Country of Publication:
- United States
- Language:
- English
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CARDIOVASCULAR DISEASES
DIAGNOSIS
HEART
SCINTISCANNING
CORONARIES
FOURIER TRANSFORMATION
PATIENTS
THALLIUM 201
ARTERIES
BETA DECAY RADIOISOTOPES
BLOOD VESSELS
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DIAGNOSTIC TECHNIQUES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
INTEGRAL TRANSFORMATIONS
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
NUCLEI
ODD-EVEN NUCLEI
ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SECONDS LIVING RADIOISOTOPES
THALLIUM ISOTOPES
TRANSFORMATIONS
550601* - Medicine- Unsealed Radionuclides in Diagnostics