title: Adherence to thresholds: overdiagnosis of left ventricular noncompaction cardiomyopathy.
abstract: Thresholds derived from quantification in imaging are increasingly used to define disease. This derivation is not an exact science. When one uses a threshold to define a disease, one does not clearly demarcate disease from normality because the threshold includes overlapping spectra of mild disease and normality. Thus, use of the threshold will mislabel normal individuals with disease. In this perspective, we will describe how the threshold has been derived for left ventricular noncompaction cardiomyopathy, the statistical biases in the design of studies used to derive the threshold, and the dangers of overdiagnosis when the threshold is used to rule out left ventricular noncompaction cardiomyopathy.
authors: Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, 9021 Gates, 3400 Spruce Street, Philadelphia, PA 19104. Electronic address: vinay.kini@uphs.upenn.edu.
authors: Vinay
authors: V
authors: Kini
authors: Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, 9021 Gates, 3400 Spruce Street, Philadelphia, PA 19104.
authors: Victor A
authors: VA
authors: Ferrari
authors: Division of Cardiovascular Medicine, The Hospital of the University of Pennsylvania, 9021 Gates, 3400 Spruce Street, Philadelphia, PA 19104.
authors: Yuchi
authors: Y
authors: Han
authors: Department of Radiology, The Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors: Saurabh
authors: S
authors: Jha
mesh_terms: D004452:Echocardiography / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D056830:Isolated Noncompaction of the Ventricular Myocardium / Q000175:diagnosis*; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D000069342:Medical Overuse / Q000517:prevention & control* / Q000639:trends*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Overdiagnosis; cardiovascular imaging; ventricular noncompaction