Chronic stable angina assessing the pretest probability of coronary artery disease
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Associate Editor-in-Chief: Smita Kohli, M.D.
Overview
Once the history and physical examination is complete, it is important to assess the probability of coronary artery disease as this helps both the physician and the patient to know what next step in diagnosis and treatment should be taken. There have been a lot of studies emphasizing the importance of assessing pretest probability of CAD for every patient. Diamond and Forrester[1] showed in their study that age, gender and type of pain are strong predictors for the likelihood of CAD. Multiple subsequent prospective studies have confirmed their conclusion.
Pretest Probability
Definition
Pretest Probability is defined as the probability of the target disorder before the result of a diagnostic test is known. The pretest probability is especially useful for:
* deciding whether its worth testing at all(test threshold) * selecting type of diagnostic test * interpreting the results of a diagnostic test * choosing whether to start therapy: a)without futher testing(treatment threshold); b)while awaiting further testing
Calculating the pretest probability for CAD
- ↑ Improved interpretation of a continuous variable in diagnostic testing: probabilistic analysis of scintigraphic rest and exercise left ventricular ejection fractions for coronary disease detection. Diamond GA, Forrester JS. Am Heart J. 1981 Aug;102(2):189-95. PMID: 7258092