Evidence map›Paper›PMID 29556770›Full record

ArticleEuropean radiology2018

Applicability and accuracy of pretest probability calculations implemented in the NICE clinical guideline for decision making about imaging in patients with chest pain of recent onset.

Robert Roehle, Viktoria Wieske, Georg M Schuetz, Pascal Gueret, Daniele Andreini, Willem Bob Meijboom, Gianluca Pontone, Mario Garcia, Hatem Alkadhi, Lily Honoris and 56 more

Erratum issuedAbstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

66 authors.

Robert RoehleDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Viktoria WieskeDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Georg M SchuetzDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Pascal GueretCardiology Department, Henri Mondor Hospital, University Paris Est Creteil, Créteil, France.
Daniele AndreiniCentro Cardiologico Monzino, IRCCS, Milan, Italy.
Willem Bob MeijboomIJsselland Ziekenhuis, Capelle a/d IJssel, The Netherlands.
Gianluca PontoneCentro Cardiologico Monzino, IRCCS, Milan, Italy.
Mario GarciaMontefiore, the University Hospital for the Albert Einstein College of Medicine, New York City, NY, USA.
Hatem AlkadhiInstitute of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland.
Lily HonorisAurora Health Care, Milwaukee, WI, USA.
Jörg HausleiterMedizinische Klinik und Poliklinik I, Ludwig-Maximilians-University of Munich, Munich, Germany.
Nuno BettencourtDepartment of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Gaia, Portugal.
Elke ZimmermannDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Sebastian LeschkaDepartment of Radiology and Nuclear Medicine Kantonsspital St. Gallen, St. Gallen, Switzerland.
Bernhard GerberDivision of Cardiology, Cardiovascular Center, Cliniques Universitaires St. Luc, Institut de Recherche Clinique et Experimentale, Brussels, Belgium.
Carlos RochitteHeart Institute - InCor - University of São Paulo Medical School, São Paulo, Brazil.
U Joseph SchoepfDepartment of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC, USA.
Abbas Arjmand ShabestariDepartment of Radiology, Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Bjarne NørgaardDepartment Cardiology B, Aarhus University Hospital Skejby, Aarhus, Denmark.
Akira SatoCardiovascular Division, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
Juhani KnuutiTurku University Hospital and University of Turku, Turku, Finland.
Matthijs F L MeijsDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
Harald BrodoefelDepartment of Radiology, University of Regensburg, Regensburg, Germany.
Shona M M JenkinsGlasgow Royal Infirmary and Stobhill Hospital, Glasgow, UK.
Kristian Altern ØvrehusDepartment of Cardiology, Odense University Hospital, Odense, Denmark.
Axel Cosmus Pyndt DiederichsenDepartment of Cardiology, Odense University Hospital, Odense, Denmark.
Ashraf HamdanDepartment of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany.
Bjørn Arild HalvorsenMedical Department, Ostfold Hospital Trust, Fredrikstad, Norway.
Vladimir Mendoza RodriguezNational Institute of Cardiology and Cardiovascular, Surgery, Havana, Cuba.
Yung Liang WanDepartment of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Johannes RixeMedizinische Klinik I (Kardiologie, Angiologie), Universitätsklinikum Giessen und Marburg GmbH, Giessen, Germany.
Mehraj SheikhDepartment of Radiology, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Christoph LangerKlinik für Innere Medizin III mit Schwerpunkt Kardiologie und Angiologie, UKSH, Kiel, Germany.
Said GhostineCardiologie diagnostique et interventionnelle, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France.
Eugenio MartuscelliDepartment of Internal Medicine, University of Rome Tor Vergata, Rome, Italy.
Hiroyuki NiinumaDepartment of Medicine, St. Luke's International Hospital, Tokyo, Japan.
Arthur ScholteDepartment of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Konstantin NikolaouDepartment of Diagnostic and Interventional Radiology, Eberhard Karls Universität Tübingen, Tübingen, Germany.
Geir UlimoenAleris Hospital, Oslo, Norway.
Zhaoqi ZhangDepartment of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Hans MickleyDepartment of Cardiology, Odense University Hospital, Odense, Denmark.
Koen NiemanDepartment of Cardiology, Erasmus Medical Center, Rotterdam, The Netherlands.
Philipp A KaufmannDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
Ronny Ralf BuechelDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
Bernhard A HerzogDepartment of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Zurich, Switzerland.
Melvin ClouseDepartment of Radiology, Beth Israel Deaconess, Harvard University, Boston, MA, USA.
David A HalonDepartment of Cardiovascular Medicine, Lady Davis Carmel Medical Center, Haifa, Israel.
Jonathan LeipsicDepartment of Radiology and Division of Cardiology UBC, St Paul's Hospital, Vancouver, Canada.
David BushDepartment of Cardiology, Johns Hopkins University, Baltimore, MD, USA.
Reda JakamyDepartment of Interventional Cardiology, University Hospital Cochin, Paris, France.
Kai SunDepartment of Radiology, Baotou Central Hospital, Baotou Shi, Inner Mongolia Province, China.
Lin YangDepartment of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Thorsten JohnsonDepartment of Clinical Radiology, Hospital Grosshadern of the University of Munich, Munich, Germany.
Jean-Pierre LaissyDepartment of Diagnostic Imaging and Interventional Radiology, Bichat University Hospital, Paris, France.
Roy MarcusDepartment of Clinical Radiology, Munich, Ludwig-Maximilians-University of Munich, Munich, Germany.
Simone MuragliaCardiology Department, S. Chiara Hospital, Trento, Italy.
Jean-Claude TardifResearch Center Montreal Heart Institute, Université de Montréal, Montréal, Canada.
Benjamin ChowUniversity of Ottawa, Heart Institute, Ottawa, Canada.
Narinder PaulJoint Department of Medical Imaging, University Health Network, Mount Sinai and Women's College Hospitals, Toronto, Canada.
David MaintzInstitute and Polyclinic for Diagnostic Radiology, University of Cologne, Cologne, Germany.
John HoeDepartment of Diagnostic Radiology, Mt Elizabeth Hospital, Singapore, Singapore.
Albert de RoosDepartment of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Robert HaaseDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Michael LauleDepartment of Cardiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany.
Peter SchlattmannDepartment of Medical Statistics, Informatics and Documentation, University Hospital of Friedrich Schiller University Jena, Jena, Germany.
Marc DeweyDepartment of Radiology, Charité - Universitätsmedizin Berlin Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Charitéplatz 1, 10117, Berlin, Germany. marc.dewey@charite.de.ORCID http://orcid.org/0000-0002-4402-2733

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo analyse the implementation, applicability and accuracy of the pretest probability calculation provided by NICE clinical guideline 95 for decision making about imaging in patients with chest pain of recent onset.

methodsThe definitions for pretest probability calculation in the original Duke clinical score and the NICE guideline were compared. We also calculated the agreement and disagreement in pretest probability and the resulting imaging and management groups based on individual patient data from the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).

results4,673 individual patient data from the CoMe-CCT Consortium were analysed. Major differences in definitions in the Duke clinical score and NICE guideline were found for the predictors age and number of risk factors. Pretest probability calculation using guideline criteria was only possible for 30.8 % (1,439/4,673) of patients despite availability of all required data due to ambiguity in guideline definitions for risk factors and age groups. Agreement regarding patient management groups was found in only 70 % (366/523) of patients in whom pretest probability calculation was possible according to both models.

conclusionsOur results suggest that pretest probability calculation for clinical decision making about cardiac imaging as implemented in the NICE clinical guideline for patients has relevant limitations. KEY POINTS: • Duke clinical score is not implemented correctly in NICE guideline 95. • Pretest probability assessment in NICE guideline 95 is impossible for most patients. • Improved clinical decision making requires accurate pretest probability calculation. • These refinements are essential for appropriate use of cardiac CT.

Indexed as

Cardiac Imaging TechniquesClinical Decision-MakingGuideline AdherencePractice Guidelines as TopicTomography, X-Ray ComputedAdultAgedChest PainFemaleHumansMaleMiddle AgedProbabilityRisk FactorsCoronary artery diseaseDuke clinical scoreMultidetector computed tomographyNICE clinical guidelinePretest probability

Identifiers

PMID29556770

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.