Evidence map›Paper›PMID 30374848›Full record

SynthesisJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2020

Umbrella review and multivariate meta-analysis of diagnostic test accuracy studies on hybrid non-invasive imaging for coronary artery disease.

Giuseppe Biondi-Zoccai, Francesco Versaci, Ami E Iskandrian, Orazio Schillaci, Alessandro Nudi, Giacomo Frati, Francesco Nudi

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–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

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Promises and pitfalls of relying on angiography-derived indexes to identify myocardial ischemia: A tale of Romulus and Remus.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022
    Article
  4. Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2020: positron emission tomography, computed tomography, and magnetic resonance.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021
    Review
  5. Observational
  6. Myocardial perfusion imaging with cadmium-zinc-telluride cameras: Harry Potter and the Radiation Hallows?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021
    Article
  7. Myocardial-coronary fusion imaging with positron emission tomography and computed tomography: Benchmarking and slingshotting.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Giuseppe Biondi-ZoccaiDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy. giuseppe.biondizoccai@uniroma1.it.
Francesco VersaciDivision of Cardiology, S. Maria Goretti Hospital, Latina, Italy.
Ami E IskandrianDivision of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA.
Orazio SchillaciIRCCS NEUROMED, Pozzilli, Italy.
Alessandro NudiReplycare, Viale Africa 36, 00144, Rome, Italy.
Giacomo FratiDepartment of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.
Francesco NudiReplycare, Viale Africa 36, 00144, Rome, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe diagnosis of coronary artery disease (CAD) remains challenging. It is uncertain whether hybrid imaging can improve diagnostic accuracy for CAD.

methodsThis is a systematic review and multivariate meta-analysis. We searched PubMed and The Cochrane Library for recent (≥ 2010) systematic reviews of diagnostic test accuracy studies on non-invasive imaging for CAD. Study-level data were extracted from them, and pooled with pairwise and multivariate meta-analytic methods, using invasive coronary angiography (ICA) or invasive fractional flow reserve (FFR) as reference standards, focusing on sensitivity and specificity.

resultsDetails from 661 original studies (71,823 patients) were pooled. Pairwise meta-analysis using ICA as reference showed that anatomic imaging was associated with the best diagnostic accuracy (sensitivity = 0.95 [95% confidence interval 0.94-0.96], specificity = 0.83 [0.81-0.85]), whereas using FFR as reference identified hybrid imaging as the best test (sensitivity = 0.87 [0.83-0.90], specificity = 0.82 [0.76-0.87]). Multivariate meta-analysis confirmed the superiority of anatomic imaging using ICA as reference (sensitivity = 0.96, specificity = 0.83), and hybrid imaging using FFR as reference (sensitivity = 0.88 [0.86-0.91], specificity = 0.82 [0.77-0.87]).

conclusionsNon-invasive hybrid imaging tests appear superior to anatomic or functional only tests to diagnose ischemia-provoking coronary lesions, whereas anatomic imaging is best to diagnose and/or rule out angiographically significant CAD. SYSTEMATIC REVIEW REGISTRATION: PROSPERO Registry Number CRD42018088528.

Indexed as

Cardiac Imaging TechniquesCoronary Artery DiseaseHumansSensitivity and SpecificityCoronary artery diseaseDiagnosisImagingMultivariate meta-analysisUmbrella review

Identifiers

PMID30374848

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.