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March 7, 2012

Evaluation for Coronary Artery Disease and Medicare Spending—Reply

Author Affiliations

Author Affiliations: Stanford University School of Medicine, Stanford, California (hlatky@stanford.edu).

JAMA. 2012;307(9):911-912. doi:10.1001/jama.307.9.912-a

In Reply: We agree with Drs Ladapo and Douglas that when a more sensitive test such as CCTA is used to evaluate patients with suspected CAD, more patients will have positive test results that could lead to additional invasive cardiac catheterizations. However, tests with higher sensitivity often have lower specificity and more false-positive results. We were unable to assess the extent of false-positive results after initial diagnostic evaluation, however, because our study was a claims analysis.

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