title: Gender differences in the diagnostic accuracy of SPECT myocardial perfusion imaging: a bivariate meta-analysis.
abstract: BACKGROUND
  It remains controversial whether the diagnostic accuracy of single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) is different in men as compared to women. We performed a meta-analysis to investigate gender differences of SPECT MPI for the diagnosis of CAD (≥50% stenosis).
  
  
  METHODS
  Two investigators independently performed a systematic review of the MEDLINE and EMBASE databases from inception through January 2012 for English-language studies determining the diagnostic accuracy of SPECT MPI. We included prospective studies that compared SPECT MPI with conventional coronary angiography which provided sufficient data to calculate gender-specific true and false positives and negatives. Data from studies evaluating <20 patients of one gender were excluded. Bivariate meta-analysis was used to create summary receiver operating curves.
  
  
  RESULTS
  Twenty-six studies met inclusion criteria, representing 1,148 women and 1,142 men. Bivariate meta-analysis yielded a mean sensitivity and specificity of 84.2% (95% confidence interval [CI] 78.7%-88.6%) and 78.7% (CI 70.0%-85.3%) for SPECT MPI in women and 89.1% (CI 84.0%-92.7%) and 71.2% (CI 60.8%-79.8%) for SPECT MPI in men. There was no significant difference in the sensitivity (P = .15) or specificity (P = .23) between male and female subjects.
  
  
  CONCLUSIONS
  In a bivariate meta-analysis of the available literature, the diagnostic accuracy of SPECT MPI is similar for both men and women.
authors.affiliation: Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA. aline_iskandar@yahoo.com
authors.forename: Aline
authors.initials: A
authors.lastname: Iskandar
authors.forename: Brendan
authors.initials: B
authors.lastname: Limone
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Parker
authors.forename: Andrew
authors.initials: A
authors.lastname: Perugini
authors.forename: Hyejin
authors.initials: H
authors.lastname: Kim
authors.forename: Charles
authors.initials: C
authors.lastname: Jones
authors.forename: Brian
authors.initials: B
authors.lastname: Calamari
authors.forename: Craig I
authors.initials: CI
authors.lastname: Coleman
authors.forename: Gary V
authors.initials: GV
authors.lastname: Heller
mesh_terms: D000704:Analysis of Variance; D003251:Constriction, Pathologic; D017023:Coronary Angiography / Q000379:methods*; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012107:Research Design; D012680:Sensitivity and Specificity; D012737:Sex Factors; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D013667:Technetium