Journal of the American Society of Echocardiography
Clinical InvestigationCAD-Stress EchocardiographyFactors Affecting Sensitivity and Specificity of Diagnostic Testing: Dobutamine Stress Echocardiography
Section snippets
Literature Review
A Medline search for diagnostic dobutamine stress echocardiographic studies published up to 2006 using the terms “dobutamine stress” and “coronary artery disease” was performed. In addition, we reviewed the reference lists of review articles and eligible studies to complete the data search. Excluded from this search were reports solely on patients with poor echocardiographic windows, left bundle branch block, hypertension, and/or left ventricular hypertrophy or prior myocardial infarction. To
Sensitivities and Specificities
For the 62 unique study groups in the 60 reports, 6881 patients were studied with DSE and coronary angiography with sufficient data to record sensitivity and specificity. Of these, 4718 had angiographic CAD, whereas 2163 did not. A total of 3882 patients had true-positive findings on DSE, resulting in a sensitivity of 0.812. There were 1790 true-negative findings, resulting in a specificity of 0.822. Sensitivities and specificities for each of the 62 study groups are reported in Table 2.
Effects of Patient Characteristics
The
Discussion
This meta-analysis indicates that patient characteristics, referral bias, and technical factors (such as the definition of positive results on DSE) all significantly affect the reported sensitivity and specificity of DSE.
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