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KCE Reports 82 Multislice CT in Coronary Heart Disease 23
In conclusion, in addition to the trials selected by Abdulla, 66 we retrieved 10 additional
primary diagnostic papers that were published in 2007 or 2008. Moreover, we selected
4 prognostic studies from 2 different research groups and 4 meta-analyses Table 5.
Table 5: Number of trials identified via different search engines and number
of trials qualified as eligible.
N identified N eligible
diagnostic outcome SR
PubMed 250 2 1 2
EMBASE (excl PubMed) 202 3 2 1
SUMSearch + handsearching 104 1 1 1
TOTAL 10 4 4
The quality of systematic reviews was assessed using the Dutch Cochrane Centre
checklist (http://www.cochrane.nl/index.html) (cf Figure 4 in the appendix to this
report). The quality of primary diagnostic papers was assessed by means of the
QUADAS tool as shown in Figure 5 and Table 18 in the appendix. 84
3.1.2 Data extraction
Demographic, methodological (clinical context, exclusion criteria) and technical data,
numbers of patients, use of beta-blocking agents, radiation exposure, numbers of true
positives, false positives, true negatives and false negatives were extracted from each
study. The results at a patient-level and the prevalence of disease (defined as at least
one >50% coronary artery narrowing by CCA) were also extracted.
Key points
• This report predominantly focuses on the diagnostic performance of
64-SCT in CAD as studied in trials that were published in the year
2007 and the beginning of 2008.
• Data are added to those from a systematic review on 64-SCT that
searched literature until April 2007 and was published in December
2007.
• We selected two relevant HTA reports, 4 systematic reviews and 10
primary diagnostic trials.
3.2 LITERATURE REVIEW
3.2.1 Health Technology Assessments
64-SCT devices were only released in the fall of 2004 and the Andalusian Agency’s
report 61 published in February 2006 was the first in the series of HTA-reports that we
retrieved that included at least one 64-SCT study. 85 Also the report from Harvard
Pilgrim included only one primary trial that made use of 64-slice technology. 35 A rapid
assessment was published by the National Horizon Scanning Unit of the Adelaide HTA 86
and incorporated two such studies. 87, 88 The most comprehensive HTA reports dealt
with MSCT for screening in asymptomatic populations, which is beyond the scope of
41, 42
the current report.
The Tec Blue Cross Blue Shield 63 report of August 2006 and the AHRQ 64 technology
assessment released in October 2006, each included six 64-SCT trials. In October 2007,
the California Technology Assessment Forum issued a report (which we did not
consider a full HTA) that can be regarded as an update of the Tec BCBC report of
August 2006 and to which it added one additional 64-SCT trial. 70