Evidence map›Paper›PMID 34235885›Full record

SynthesisJournal of medical radiation sciences2021

Diagnostic accuracy of prospectively gated, 128-slice or greater CTCA at high heart rates: a systematic review and meta-analysis.

Gordon T W Mander, Karen Dobeli, Caitlin Steffensen, Zachary Munn

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of medical radiation sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Review
  3. 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

4 authors.

Gordon T W ManderToowoomba Hospital, Darling Downs Health, Queensland Health, Toowoomba, Queensland, Australia.ORCID https://orcid.org/0000-0002-2817-6871
Karen DobeliRoyal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Queensland Health, Herston, Queensland, Australia.ORCID https://orcid.org/0000-0001-6655-8566
Caitlin SteffensenFaculty of Health Sciences, Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, Australia.
Zachary MunnFaculty of Health Sciences, Joanna Briggs Institute, University of Adelaide, Adelaide, South Australia, Australia.

Funding

Australian Government Research Training Program (RTP) ScholarshipAustralian Society of Medical Imaging and Radiation Therapy (ASMIRT) 2018 Research Scholarship Grant
6 · The paper itself

Abstract

introductionProspectively gated 64-slice CT coronary angiography (CTCA) may be contraindicated for heart rates (HRs) over 65 beats per minute (bpm) due to reduced diagnostic sensitivity. Newer CT scanners typically provide 128 or more slices and superior temporal resolution compared with older models; consequently, diagnostic accuracy for current technology prospectively gated CTCA may be adequate at HRs above 65 bpm. The aim of this systematic review was to investigate the diagnostic accuracy of CTCA using 128-slice or greater CT technology when compared with conventional coronary angiography for patients with HRs >65 bpm.

methodsA systematic search of PubMed, CINAHL, EMBASE and Scopus was performed as well as unpublished databases, sources and reference lists. Titles and abstracts were screened by two independent reviewers. Full-text screening was then performed. Studies that determined diagnostic accuracy of coronary artery stenosis in adult patients with high heart rates utilising prospectively gated 128 detector or greater scanners were included. Studies that were included in the review underwent critical appraisal using the QUADAS-2 tool.

resultsTen studies were included in the systematic review, with nine of these included in a diagnostic test accuracy meta-analysis, including six of which reported data at the patient level. Meta-analysis indicated very high pooled sensitivity 100% (95% CI 0.99, 1.00); however, pooled specificity was less at 79% (95% CI 0.69, 0.88).

conclusionsProspectively gated CT coronary angiography may be justifiable at heart rates above 65 bpm if performed on a 128-slice or greater CT unit. Caution regarding the implication of a positive result is recommended due to reduced specificity. Further evidence is required before consideration of a new higher heart threshold.

Indexed as

ElectrocardiographyTomography, X-Ray ComputedAdultCoronary AngiographyHeart RateHumansCardiac computed tomographycomputed tomographydiagnostic test accuracymeta-analysissensitivity and specificitysinus tachycardia

Identifiers

PMID34235885
PMCPMC8656183

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Registered trials

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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.