title: Diagnostic performance of coronary computed tomography angiography versus exercise electrocardiography for coronary artery disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Both coronary computed tomography angiography (CCTA) and exercise electrocardiography (ExECG) are non-invasive testing methods for the evaluation of coronary artery disease (CAD). However, there was controversy on the diagnostic performance of these methods due to the limited data in each single study. Therefore, we performed a meta-analysis to address these issues.
  
  
  METHODS
  We searched PubMed and Embase databases up to May 22, 2015. Two authors identified eligible studies, extracted data and accessed quality. Pooled estimation of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), summary receiver-operating characteristic curve (SROC) and the area under curve (AUC) of CCTA and ExECG for the diagnosis of CAD were calculated using Stata, Meta-Disc and Review Manager statistical software.
  
  
  RESULTS
  Seven articles were included. Pooled sensitivity of CCTA and ExECG were 0.98 [95% confidence intervals (CIs): 0.95-0.99] and 0.66 (95% CIs: 0.59-0.72); pooled specificity of CCTA and ExECG were 0.84 (95% CIs: 0.81-0.87) and 0.75 (95% CIs: 0.71-0.79); pooled DOR of CCTA and ExECG were 110.24 (95% CIs: 35.07-346.55) and 6.28 (95% CIs: 2.06-19.13); and AUC of CCTA and ExECG were 0.9950±0.0046 and 0.7727±0.0638, respectively. There is no heterogeneity caused by threshold effect in CCTA or ExECG analysis. The Deeks' test showed no potential publication bias (P=0.17).
  
  
  CONCLUSIONS
  CCTA has better diagnostic performance than ExECG in the evaluation of CAD, which can provide a better solution for the clinical problem of the diagnosis for CAD.
authors: Department of Emergency, Qilu Hospital, Shandong University, Jinan 250012, China;; School of Clinical Medicine, Taishan Medical University, Taian 271016, China;
authors: Xinxin
authors: X
authors: Yin
authors: Department of Emergency, Qilu Hospital, Shandong University, Jinan 250012, China;; Chest Pain Center, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Cardiovascular Remodeling & Function Research, Chinese Ministry of Education & Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan 250012, China.
authors: Jiali
authors: J
authors: Wang
authors: Department of Emergency, Qilu Hospital, Shandong University, Jinan 250012, China;; Chest Pain Center, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Cardiovascular Remodeling & Function Research, Chinese Ministry of Education & Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan 250012, China.
authors: Wen
authors: W
authors: Zheng
authors: Department of Emergency, Qilu Hospital, Shandong University, Jinan 250012, China;; Chest Pain Center, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Cardiovascular Remodeling & Function Research, Chinese Ministry of Education & Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan 250012, China.
authors: Jingjing
authors: J
authors: Ma
authors: Key Laboratory of Cardiovascular Remodeling & Function Research, Chinese Ministry of Education & Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan 250012, China.
authors: Panpan
authors: P
authors: Hao
authors: Department of Emergency, Qilu Hospital, Shandong University, Jinan 250012, China;; Chest Pain Center, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Shandong University, Jinan 250012, China;; Key Laboratory of Cardiovascular Remodeling & Function Research, Chinese Ministry of Education & Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan 250012, China.
authors: Yuguo
authors: Y
authors: Chen
keywords: Coronary computed tomography angiography (CCTA); coronary artery disease (CAD); diagnostic performance; exercise electrocardiography (ExECG); meta-analysis