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A Useful Test to Screen for Coronary Heart Disease?

Dariush Mozaffarian, MD, MPH

JAMA. 2005;294:2897-2901.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Electron-beam computed tomography (EBCT) uses x-rays generated by electron-beam irradiation of a tungsten target to identify and quantify coronary artery calcium (CAC).¹ Initial studies focused on the use of EBCT for risk stratification or diagnosis among individuals with clinical symptoms of coronary heart disease (CHD).^1-3 However, more recent articles,^4-14 as well as marketing by for-profit companies,^15-16 have focused on using EBCT for screening; that is, for detection of CHD in asymptomatic individuals.

When considering the potential value of EBCT for screening, it is critical to keep in mind generally accepted principles for what constitutes an effective screening test^17-18:

Disease.—The disease should be common and of public health consequence, have an extended preclinical stage, and result in preventable morbidity or mortality.

Diagnosis.—The screening test must accurately classify asymptomatic individuals in the population of interest as likely to have or not have the disease.

Therapy.—Detection of subclinical . . . [Full Text of this Article]