To the Editor In an Original Investigation published in a recent issue of JAMA Internal Medicine, Foy et al1 computed that to avoid 1 myocardial infarction (MI), 250 people need to have coronary computed tomographic angiography (CCTA) instead of functional testing. They also computed that for every 37 people scanned by CCTA, there will be 1 excess revascularization procedure. Foy et al “…hypothesize that at least some of these additional procedures are associated with the finding of incidental CAD that is not causing symptomatic ischemia and would not have been detected with functional stress testing alone.”1(p1630) They refer to the contentious issue of overdiagnosis and overtreatment, most notably observed in the breast cancer screening debate.2
Tsarpalis K. Coronary Computed Tomographic Angiography and Potential for Overtreatment. JAMA Intern Med. 2018;178(3):435–436. doi:10.1001/jamainternmed.2017.8647
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