Circ Cardiovasc Qual Outcomes

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Presentation transcript:

Circ Cardiovasc Qual Outcomes Understanding the Utility of Zero Coronary Calcium as a Prognostic Test by Michael J. Blaha, Roger S. Blumenthal, Matthew J. Budoff, and Khurram Nasir Circ Cardiovasc Qual Outcomes Volume 4(2):253-256 March 15, 2011 Copyright © American Heart Association, Inc. All rights reserved.

Mathematical representation of Bayes theorem. Mathematical representation of Bayes theorem. The probability of a disease being present (A) given the results of a test (B) dependent not only on the characteristics of the test P(B A), but also on the prior probability distribution of the disease in the tested population P(A). The term P(B) is called the normalizing constant, interpreted as the marginal probability of B, and is required to make the Bayes equation fit a probability density function. Michael J. Blaha et al. Circ Cardiovasc Qual Outcomes. 2011;4:253-256 Copyright © American Heart Association, Inc. All rights reserved.

A Bayesian approach is critical for discerning the value of tests. A Bayesian approach is critical for discerning the value of tests. A Bayesian analysis points to situations where CAC=0 is helpful (intermediate-risk asymptomatic patients, low-risk symptomatic patients) and where it is not helpful (very-low-risk asymptomatic patients, higher-risk symptomatic patients). Studies like that by Taylor et al4 have helped to define the lower boundary for CAC testing. Michael J. Blaha et al. Circ Cardiovasc Qual Outcomes. 2011;4:253-256 Copyright © American Heart Association, Inc. All rights reserved.