Trial reportJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2007
A randomized trial of exercise treadmill ECG versus stress SPECT myocardial perfusion imaging as an initial diagnostic strategy in stable patients with chest pain and suspected CAD: cost analysis.
Trial report in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 11 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled it
- Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials.BMJ (Clinical research ed.) · 2018Pooled it
- Diagnostic and prognostic comparison of stress electrocardiogram, cardiovascular magnetic resonance, and single photon emission computed tomography, alone and sequentially, in stable chest pain.Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance · 2025Trial
- Current status and perspectives of nuclear cardiology.Annals of nuclear medicine · 2024Review
- Use of the Walking Impairment Questionnaire and Walking Estimated-Limitation Calculated by History questionnaire to detect maximal walking distance equal to or lower than 250 m in patients with lower extremity arterial disease.Frontiers in cardiovascular medicine · 2023Article
- Could heart rate recovery and exercise capacity predict abnormal 99mTc-MIBI myocardial perfusion scan findings?Global cardiology science & practice · 2021Article
- Coronary Computed Tomography Angiography Improving Outcomes in Patients with Chest Pain.Current cardiovascular imaging reports · 2019Article
- Relative diagnostic, prognostic and economic value of stress echocardiography versus exercise electrocardiography as initial investigation for the detection of coronary artery disease in patients with new onset suspected angina.International journal of cardiology. Heart & vasculature · 2015Article
- Nuclear scan strategy and outcomes in chest pain patients value of stress testing with dipyridamole or adenosine.World journal of nuclear medicine · 2014Article
- The price for probability: Comparing the costs of diagnostic testing strategies.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2007Article
- Application of exercise ECG stress test in the current high cost modern-era healthcare system.Indian heart journalReview
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExercise electrocardiography (ETT) is frequently used in patients with suspected coronary artery disease (CAD). Single photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) improves diagnostic stratification. There are no randomized trials comparing ETT and MPI. We hypothesized that first-line MPI would be effective and cost-saving versus ETT. METHODS AND
resultsWe randomized 457 outpatients with stable chest pain and suspected CAD to either treadmill electrocardiography or MPI. The post-test likelihood incorporated the pretest likelihood and the test result, with clinically driven testing. The primary endpoint was cost to diagnosis based on institutional and National Institute for Clinical Excellence costs. MPI significantly reduced the intermediate post-test likelihood of CAD (30% for ETT vs 3% for MPI, P < .0001) and further investigations (71% for ETT vs 16% for MPI, P < .0001). Despite the reduction in downstream resource utilization after MPI, mean costs were not different between the 2 initial strategies: 490.44 pounds sterling (95% confidence interval, 453.80-527.08) for ETT versus 512.41 pounds sterling (95% confidence interval, 481.41-543.41) for MPI. MPI cost was no different from ETT cost in patients with an intermediate or high pretest likelihood (P = not significant). ETT was less expensive in low-risk patients.
conclusionsIn this study there was no difference in cost to diagnosis between initial ETT and MPI. In low-likelihood patients ETT was less costly, whereas there was no cost difference in intermediate- or high-likelihood patients.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.