Similar to a recent study posted on 11/18, in this multi-center study of 291 patients with chest pain and suspected CAD, patients underwent both coronary CTA and catheterization (abstract). This study found the PPV of CTA (compared to catheterization) was 91% and the NPV was 83% for detecting >50% coronary artery obstruction (in patients with a BMI<40 and a calcium score <600). From this the authors determined that CTA has “reliable accuracy for the diagnosis of obstructive coronary disease” but also argue that it is not appropriate to replace catheterization with CTA, given it is not a perfect test and given the higher radiation exposure with CTA. Since the diagnostic performance of CTA is study/site/reader-specific, it still remains to be seen the best way to utilize this technology.
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]
By reading the headlines recently, practitioners would not know if they saved or tanked the healthcare system. One day disaster looms, the next we have moderated growth and business can continue as usual (and by business, I mean doing the correct things correctly). A new study, along with some recent data, helps shed some light […]