Table 3.
Resource Utilization, Radiation Exposure, and Costs of Care.*
| Variable | Index Visit | Index Plus Follow-up Visit | ||||
|---|---|---|---|---|---|---|
| CCTA (N = 501) | Standard Evaluation (N = 499) | P Value | CCTA (N = 501) | Standard Evaluation (N = 499) | P Value | |
| Diagnostic testing — no. of patients (%)† | <0.001 | <0.001 | ||||
| No testing‡ | 9 (2) | 109 (22) | 9 (2) | 89 (18) | ||
| 1 test | 376 (75) | 337 (68) | 359 (72) | 350 (70) | ||
| ≥2 tests | 116 (23) | 53 (11) | 133 (27) | 60 (12) | ||
| Functional testing — no. (%)§ | <0.001 | <0.001 | ||||
| SPECT | 50 (10) | 124 (25) | 58 (12) | 133 (27) | ||
| Stress echocardiography | 20 (4) | 102 (20) | 20 (4) | 102 (20) | ||
| ETT | 12 (2) | 147 (29) | 22 (4) | 162 (32) | ||
| Invasive coronary angiography — no. (%) | 54 (11) | 36 (7) | 0.06 | 59 (12) | 40 (8) | 0.06 |
| Intervention — no. (%) | ||||||
| PCI | 24 (5) | 14 (3) | 0.14 | 27 (5) | 17 (3) | 0.16 |
| CABG | 5 (1) | 4 (1) | 0.99 | 5 (1) | 4 (1) | 0.99 |
| Cumulative radiation exposure — mSv/patient¶ | 13.9±10.4 | 4.7±8.4 | <0.001 | 14.3±10.9 | 5.3±9.6 | <0.001 |
| Costs of care — U.S. dollars∥ | <0.001 | |||||
| Emergency department | ||||||
| Mean | 2,101±1,070 | 2,566±1,323 | ||||
| Median | 1,770 | 2,293 | ||||
| Interquartile range | 1,435–2,161 | 1,592–3,583 | ||||
| Hospital | 0.19 | |||||
| Mean | 1,925±6,697 | 1,308±5,333 | ||||
| Total | 0.75 | 0.65 | ||||
| Mean | 4,026±6,792 | 3,874±5,298 | 4,289±7,110 | 4,060±5,452 | ||
| Median | 1,937 | 2,742 | 1,946 | 2,809 | ||
| Interquartile range | 1,504–4,057 | 1,755–3,832 | 1,514–4,164 | 1,822–4,060 | ||
Plus–minus values are means ±SD. Percentages may not sum to 100 because of rounding. CABG denotes coronary-artery bypass grafting, ETT exercise treadmill testing, PCI percutaneous coronary intervention, and SPECT single-photon-emission computed tomography.
Diagnostic testing included CCTA, ETT, SPECT, stress echocardiography, and invasive coronary angiography.
Serial measurement of biomarkers and electrocardiographic testing were not considered as diagnostic tests in this table.
At the index visit, functional testing was the second test in the CCTA group and the first test in the standard-evaluation group.
Radiation exposure included exposure from CCTA, SPECT, and invasive coronary angiography.
Costs included those for patients discharged directly from the emergency department and those discharged from an observation unit.