Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography: protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).

Georg M. Schuetz, Peter Schlattmann, Stephan Achenbach, Matthew Budoff, Mario J. Garcia, Robert Roehle, Gianluca Pontone, Willem Bob Meijboom, Daniele Andreini, Hatem Alkadhi, Lily Honoris, Nuno Bettencourt, Jörg Hausleiter, Sebastian Leschka, Bernhard L. Gerber, Matthijs Fl Meijs, Abbas Arjmand Shabestari, Akira Sato, Elke Zimmermann, Uwe J. SchoepfAxel Diederichsen, David A. Halon, Vladimir Mendoza-Rodriguez, Ashraf Hamdan, Bjarne L. Nørgaard, Harald Brodoefel, Kristian A. Ovrehus, Shona Mm Jenkins, Bjørn A. Halvorsen, Johannes Rixe, Mehraj Sheikh, Christoph Langer, Eugenio Martuscelli, Andrea Romagnoli, Arthur Jha Scholte, Roy P. Marcus, Geir R. Ulimoen, Koen Nieman, Hans Mickley, Konstantin Nikolaou, Jean Claude Tardif, Thorsten Rc Johnson, Simone Muraglia, Benjamin Jw Chow, David Maintz, Michael Laule, Marc Dewey

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest likelihood of coronary artery disease. A bivariate random-effects model will be used to calculate pooled mean negative and positive predictive values as well as sensitivity and specificity. The primary outcome of interest will be positive and negative predictive values of coronary computed tomography angiography for the presence of coronary artery disease as a function of pretest likelihood of coronary artery disease, analyzed by meta-regression. As a secondary endpoint, factors that may influence the diagnostic performance and clinical value of computed tomography, such as heart rate and body mass index of patients, number of detector rows, and administration of beta blockade and nitroglycerin, will be investigated by integrating them as further covariates into the bivariate random-effects model. This collaborative individual patient data meta-analysis should provide answers to the pivotal question of which patients benefit most from noninvasive coronary computed tomography angiography and thus help to adequately select the right patients for this test.

Original languageEnglish
Pages (from-to)13
Number of pages1
JournalSystematic Reviews
Volume2
DOIs
Publication statusPublished - 2013

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Meta-Analysis
Coronary Artery Disease
Coronary Angiography
Computed Tomography Angiography
Databases
Likelihood Functions
Health Services Needs and Demand
Coronary Stenosis
Nitroglycerin
Patient Rights
Coronary Vessels
Pathologic Constriction
Body Mass Index
Heart Rate
Tomography
Sensitivity and Specificity

ASJC Scopus subject areas

  • Medicine (miscellaneous)

Cite this

Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography : protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT). / Schuetz, Georg M.; Schlattmann, Peter; Achenbach, Stephan; Budoff, Matthew; Garcia, Mario J.; Roehle, Robert; Pontone, Gianluca; Meijboom, Willem Bob; Andreini, Daniele; Alkadhi, Hatem; Honoris, Lily; Bettencourt, Nuno; Hausleiter, Jörg; Leschka, Sebastian; Gerber, Bernhard L.; Meijs, Matthijs Fl; Shabestari, Abbas Arjmand; Sato, Akira; Zimmermann, Elke; Schoepf, Uwe J.; Diederichsen, Axel; Halon, David A.; Mendoza-Rodriguez, Vladimir; Hamdan, Ashraf; Nørgaard, Bjarne L.; Brodoefel, Harald; Ovrehus, Kristian A.; Jenkins, Shona Mm; Halvorsen, Bjørn A.; Rixe, Johannes; Sheikh, Mehraj; Langer, Christoph; Martuscelli, Eugenio; Romagnoli, Andrea; Scholte, Arthur Jha; Marcus, Roy P.; Ulimoen, Geir R.; Nieman, Koen; Mickley, Hans; Nikolaou, Konstantin; Tardif, Jean Claude; Johnson, Thorsten Rc; Muraglia, Simone; Chow, Benjamin Jw; Maintz, David; Laule, Michael; Dewey, Marc.

In: Systematic Reviews, Vol. 2, 2013, p. 13.

Research output: Contribution to journalArticle

Schuetz, GM, Schlattmann, P, Achenbach, S, Budoff, M, Garcia, MJ, Roehle, R, Pontone, G, Meijboom, WB, Andreini, D, Alkadhi, H, Honoris, L, Bettencourt, N, Hausleiter, J, Leschka, S, Gerber, BL, Meijs, MF, Shabestari, AA, Sato, A, Zimmermann, E, Schoepf, UJ, Diederichsen, A, Halon, DA, Mendoza-Rodriguez, V, Hamdan, A, Nørgaard, BL, Brodoefel, H, Ovrehus, KA, Jenkins, SM, Halvorsen, BA, Rixe, J, Sheikh, M, Langer, C, Martuscelli, E, Romagnoli, A, Scholte, AJ, Marcus, RP, Ulimoen, GR, Nieman, K, Mickley, H, Nikolaou, K, Tardif, JC, Johnson, TR, Muraglia, S, Chow, BJ, Maintz, D, Laule, M & Dewey, M 2013, 'Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography: protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).', Systematic Reviews, vol. 2, pp. 13. https://doi.org/10.1186/2046-4053-2-13
Schuetz, Georg M. ; Schlattmann, Peter ; Achenbach, Stephan ; Budoff, Matthew ; Garcia, Mario J. ; Roehle, Robert ; Pontone, Gianluca ; Meijboom, Willem Bob ; Andreini, Daniele ; Alkadhi, Hatem ; Honoris, Lily ; Bettencourt, Nuno ; Hausleiter, Jörg ; Leschka, Sebastian ; Gerber, Bernhard L. ; Meijs, Matthijs Fl ; Shabestari, Abbas Arjmand ; Sato, Akira ; Zimmermann, Elke ; Schoepf, Uwe J. ; Diederichsen, Axel ; Halon, David A. ; Mendoza-Rodriguez, Vladimir ; Hamdan, Ashraf ; Nørgaard, Bjarne L. ; Brodoefel, Harald ; Ovrehus, Kristian A. ; Jenkins, Shona Mm ; Halvorsen, Bjørn A. ; Rixe, Johannes ; Sheikh, Mehraj ; Langer, Christoph ; Martuscelli, Eugenio ; Romagnoli, Andrea ; Scholte, Arthur Jha ; Marcus, Roy P. ; Ulimoen, Geir R. ; Nieman, Koen ; Mickley, Hans ; Nikolaou, Konstantin ; Tardif, Jean Claude ; Johnson, Thorsten Rc ; Muraglia, Simone ; Chow, Benjamin Jw ; Maintz, David ; Laule, Michael ; Dewey, Marc. / Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography : protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT). In: Systematic Reviews. 2013 ; Vol. 2. pp. 13.
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abstract = "Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest likelihood of coronary artery disease. A bivariate random-effects model will be used to calculate pooled mean negative and positive predictive values as well as sensitivity and specificity. The primary outcome of interest will be positive and negative predictive values of coronary computed tomography angiography for the presence of coronary artery disease as a function of pretest likelihood of coronary artery disease, analyzed by meta-regression. As a secondary endpoint, factors that may influence the diagnostic performance and clinical value of computed tomography, such as heart rate and body mass index of patients, number of detector rows, and administration of beta blockade and nitroglycerin, will be investigated by integrating them as further covariates into the bivariate random-effects model. This collaborative individual patient data meta-analysis should provide answers to the pivotal question of which patients benefit most from noninvasive coronary computed tomography angiography and thus help to adequately select the right patients for this test.",
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T1 - Individual patient data meta-analysis for the clinical assessment of coronary computed tomography angiography

T2 - protocol of the Collaborative Meta-Analysis of Cardiac CT (CoMe-CCT).

AU - Schuetz, Georg M.

AU - Schlattmann, Peter

AU - Achenbach, Stephan

AU - Budoff, Matthew

AU - Garcia, Mario J.

AU - Roehle, Robert

AU - Pontone, Gianluca

AU - Meijboom, Willem Bob

AU - Andreini, Daniele

AU - Alkadhi, Hatem

AU - Honoris, Lily

AU - Bettencourt, Nuno

AU - Hausleiter, Jörg

AU - Leschka, Sebastian

AU - Gerber, Bernhard L.

AU - Meijs, Matthijs Fl

AU - Shabestari, Abbas Arjmand

AU - Sato, Akira

AU - Zimmermann, Elke

AU - Schoepf, Uwe J.

AU - Diederichsen, Axel

AU - Halon, David A.

AU - Mendoza-Rodriguez, Vladimir

AU - Hamdan, Ashraf

AU - Nørgaard, Bjarne L.

AU - Brodoefel, Harald

AU - Ovrehus, Kristian A.

AU - Jenkins, Shona Mm

AU - Halvorsen, Bjørn A.

AU - Rixe, Johannes

AU - Sheikh, Mehraj

AU - Langer, Christoph

AU - Martuscelli, Eugenio

AU - Romagnoli, Andrea

AU - Scholte, Arthur Jha

AU - Marcus, Roy P.

AU - Ulimoen, Geir R.

AU - Nieman, Koen

AU - Mickley, Hans

AU - Nikolaou, Konstantin

AU - Tardif, Jean Claude

AU - Johnson, Thorsten Rc

AU - Muraglia, Simone

AU - Chow, Benjamin Jw

AU - Maintz, David

AU - Laule, Michael

AU - Dewey, Marc

PY - 2013

Y1 - 2013

N2 - Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest likelihood of coronary artery disease. A bivariate random-effects model will be used to calculate pooled mean negative and positive predictive values as well as sensitivity and specificity. The primary outcome of interest will be positive and negative predictive values of coronary computed tomography angiography for the presence of coronary artery disease as a function of pretest likelihood of coronary artery disease, analyzed by meta-regression. As a secondary endpoint, factors that may influence the diagnostic performance and clinical value of computed tomography, such as heart rate and body mass index of patients, number of detector rows, and administration of beta blockade and nitroglycerin, will be investigated by integrating them as further covariates into the bivariate random-effects model. This collaborative individual patient data meta-analysis should provide answers to the pivotal question of which patients benefit most from noninvasive coronary computed tomography angiography and thus help to adequately select the right patients for this test.

AB - Coronary computed tomography angiography has become the foremost noninvasive imaging modality of the coronary arteries and is used as an alternative to the reference standard, conventional coronary angiography, for direct visualization and detection of coronary artery stenoses in patients with suspected coronary artery disease. Nevertheless, there is considerable debate regarding the optimal target population to maximize clinical performance and patient benefit. The most obvious indication for noninvasive coronary computed tomography angiography in patients with suspected coronary artery disease would be to reliably exclude significant stenosis and, thus, avoid unnecessary invasive conventional coronary angiography. To do this, a test should have, at clinically appropriate pretest likelihoods, minimal false-negative outcomes resulting in a high negative predictive value. However, little is known about the influence of patient characteristics on the clinical predictive values of coronary computed tomography angiography. Previous regular systematic reviews and meta-analyses had to rely on limited summary patient cohort data offered by primary studies. Performing an individual patient data meta-analysis will enable a much more detailed and powerful analysis and thus increase representativeness and generalizability of the results. The individual patient data meta-analysis is registered with the PROSPERO database (CoMe-CCT, CRD42012002780). The analysis will include individual patient data from published and unpublished prospective diagnostic accuracy studies comparing coronary computed tomography angiography with conventional coronary angiography. These studies will be identified performing a systematic search in several electronic databases. Corresponding authors will be contacted and asked to provide obligatory and additional data. Risk factors, previous test results and symptoms of individual patients will be used to estimate the pretest likelihood of coronary artery disease. A bivariate random-effects model will be used to calculate pooled mean negative and positive predictive values as well as sensitivity and specificity. The primary outcome of interest will be positive and negative predictive values of coronary computed tomography angiography for the presence of coronary artery disease as a function of pretest likelihood of coronary artery disease, analyzed by meta-regression. As a secondary endpoint, factors that may influence the diagnostic performance and clinical value of computed tomography, such as heart rate and body mass index of patients, number of detector rows, and administration of beta blockade and nitroglycerin, will be investigated by integrating them as further covariates into the bivariate random-effects model. This collaborative individual patient data meta-analysis should provide answers to the pivotal question of which patients benefit most from noninvasive coronary computed tomography angiography and thus help to adequately select the right patients for this test.

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