title: Diagnostic models of the pre-test probability of stable coronary artery disease: A systematic review.
abstract: A comprehensive search of PubMed and Embase was performed in January 2015 to examine the available literature on validated diagnostic models of the pre-test probability of stable coronary artery disease and to describe the characteristics of the models. Studies that were designed to develop and validate diagnostic models of pre-test probability for stable coronary artery disease were included. Data regarding baseline patient characteristics, procedural characteristics, modeling methods, metrics of model performance, risk of bias, and clinical usefulness were extracted. Ten studies involving the development of 12 models and two studies focusing on external validation were identified. Seven models were validated internally, and seven models were validated externally. Discrimination varied between studies that were validated internally (C statistic 0.66-0.81) and externally (0.49-0.87). Only one study presented reclassification indices. The majority of better performing models included sex, age, symptoms, diabetes, smoking, and hyperlipidemia as variables. Only two diagnostic models evaluated the effects on clinical decision making processes or patient outcomes. Most diagnostic models of the pre-test probability of stable coronary artery disease have had modest success, and very few present data regarding the effects of these models on clinical decision making processes or patient outcomes.
authors.affiliation: Central South University, The Third Xiangya Hospital, Department of Cardiology, Changsha 410013, The People's Republic of China.
authors.forename: Ting
authors.initials: T
authors.lastname: He
authors.affiliation: Central South University, The Third Xiangya Hospital, Department of Cardiology, Changsha 410013, The People's Republic of China.
authors.forename: Xing
authors.initials: X
authors.lastname: Liu
authors.affiliation: Central South University, The Third Xiangya Hospital, Center of Clinical Pharmacology, Changsha 410013, The People's Republic of China.
authors.forename: Nana
authors.initials: N
authors.lastname: Xu
authors.affiliation: Central South University, The Third Xiangya Hospital, Center of Clinical Pharmacology, Changsha 410013, The People's Republic of China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Central South University, The Third Xiangya Hospital, Department of Cardiology, Changsha 410013, The People's Republic of China.
authors.forename: Qiaoyu
authors.initials: Q
authors.lastname: Wu
authors.affiliation: The First Hospital of Beijing University, Department of Gerontology, Beijing, The People's Republic of China.
authors.forename: Meilin
authors.initials: M
authors.lastname: Liu
authors.affiliation: Central South University, The Third Xiangya Hospital, Department of Cardiology, Changsha 410013, The People's Republic of China.|Central South University, The Third Xiangya Hospital, Center of Clinical Pharmacology, Changsha 410013, The People's Republic of China.
authors.forename: Hong
authors.initials: H
authors.lastname: Yuan
mesh_terms: D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors