Noninvasive Technologies for Diagnosing Coronary Artery Disease in Women
Gaps in Knowledge and Future Research Needs (1 of 2)
In routine clinical practice, clinicians order one type of noninvasive technology (NIT), whether functional or anatomic, based on a patient’s ability to exercise, test availability, and clinician preference. A comparison of a functional testing strategy to an anatomic testing strategy for patients with symptomatic chest pain is currently being done in two large clinical trials The information from these clinical trials could inform how the choice of an NIT affects prognosis, treatment decisions, and clinical outcomes.
After excluding the women-only studies that were included in this review, the studies with both sexes had low representation of women. To assess sex differences in the diagnostic accuracy of NITs or their impact on clinical outcomes, a sufficient sample size is required to have adequate statistical power for subgroup analyses.
It is suggested that clinical factors such as weight, heart size, functional status, race/ethnicity, sex, age, and menopausal status can influence the diagnostic accuracy of the various NITs. However, the review found very few comparative studies that examined the impact of these clinical and demographic factors on the sensitivity and specificity of NIT results. More evidence about predictors affecting diagnostic cardiac testing is needed.
Keywords: knowledge gaps | future research needs | coronary artery disease | CAD | women | diagnosis | noninvasive technologies
- Dolor RJ, Patel MR, Melloni C, et al. Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women. Comparative Effectiveness Review No. 58 (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10061-I). Rockville, MD: Agency for Healthcare Research and Quality; June 2012. AHRQ Publication No. 12-EHC034-EF. Available at www.effectivehealthcare.ahrq.gov/diagnosecad.cfm.
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