Stress radionuclide imaging versus stress echocardiography: a framework for comparisons.
Comparisons of stress-imaging procedures require analyses based on their 2 principal applications: diagnostic and prognostic assessments. Besides comparing results reported in the literature--in which differences have been reported in the ability of stress nuclear versus stress echocardiographic imaging to predict a low risk of cardiac events-other factors often not reported may be important in discerning the relative efficacy of these tests. These include consideration of how these tests perform in specific, individualized patient scenarios; the effect of on-going technical advances on test usefulness; and evaluation of test worthiness according to such factors as cost-effectiveness and the magnitude of incremental test information that is provided. Furthermore, it is important to distinguish between a test's efficacy (ie, its intrinsic accuracy) and its effectiveness (ie, how it performs in the real world of clinical practice).
Rozanski
A
A
Department of Medicine, St Luke's-Roosevelt Hospital Center, New York, NY 10025, USA.
Gottdiener
J S
JS
D003327:Coronary Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography; D005080:Exercise Test; D006334:Heart Function Tests; D006801:Humans; D016013:Likelihood Functions; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity