title: Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease.
abstract: OBJECTIVE
  To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD).
  
  
  METHODS
  Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other.
  
  
  RESULTS
  Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging.
  
  
  CONCLUSIONS
  As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.
authors.affiliation: The Department of Medicine and Radiology, Weill Medical College of Cornell University, Dalio Institute of Cardiovascular Imaging, The New York Presbyterian Hospital, New York, NY, United States. Electronic address: jkm2001@med.cornell.edu.
authors.forename: James K
authors.initials: JK
authors.lastname: Min
authors.affiliation: Xcenda Corporation, Palm Harbor, FL, United States.
authors.forename: Amanda
authors.initials: A
authors.lastname: Gilmore
authors.affiliation: The Department of Medicine and Radiology, Weill Medical College of Cornell University, Dalio Institute of Cardiovascular Imaging, The New York Presbyterian Hospital, New York, NY, United States.
authors.forename: Erica C
authors.initials: EC
authors.lastname: Jones
authors.affiliation: Emory University School of Medicine, Atlanta, GA, United States.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Berman
authors.affiliation: The Department of Medicine and Radiology, Weill Medical College of Cornell University, Dalio Institute of Cardiovascular Imaging, The New York Presbyterian Hospital, New York, NY, United States.
authors.forename: Wijnand J
authors.initials: WJ
authors.lastname: Stuijfzand
authors.affiliation: Cedars Sinai Medical Center, Los Angeles, CA, United States.
authors.forename: Leslee J
authors.initials: LJ
authors.lastname: Shaw
authors.affiliation: Xcenda Corporation, Palm Harbor, FL, United States.
authors.forename: Ken
authors.initials: K
authors.lastname: O'Day
authors.affiliation: The Department of Medicine and Radiology, Weill Medical College of Cornell University, Dalio Institute of Cardiovascular Imaging, The New York Presbyterian Hospital, New York, NY, United States.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Danad
mesh_terms: D001158:Arteries; D002637:Chest Pain / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000191:economics; D017023:Coronary Angiography / Q000191:economics / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000191:economics; D003362:Cost-Benefit Analysis; D004452:Echocardiography / Q000191:economics / Q000379:methods; D005080:Exercise Test / Q000191:economics / Q000379:methods; D006334:Heart Function Tests / Q000191:economics / Q000379:methods; D006801:Humans; D055414:Myocardial Perfusion Imaging / Q000191:economics / Q000379:methods; D013909:Thorax; D015899:Tomography, Emission-Computed, Single-Photon / Q000191:economics / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods
keywords: Computed tomography; Cost effectiveness; Echocardiography; Invasive angiography; Myocardial perfusion SPECT; Stress testing