Table 3.
Short-term outcomes – Comparison between four competing management strategies.
| ROMICAT II CCTA* | ROMICATI SOC* | Expert Consensus* | Expedited ED Protocol* | |
|---|---|---|---|---|
| Length of Hospital Stay (hours) | 23.4 | 30.6 | 30.9 | 12.3 |
| Noninvasive Diagnostic testing | ||||
| CCTA (%) | 100.0 | 0.0 | 0.0 | 0.0 |
| SPECT (%) | 8.8 | 29.8 | 22.1 | 8.2 |
| Stress ECHO (%) | 1.3 | 20.6 | 28.4 | 10.5 |
| ETT (%) | 1.2 | 32.5 | 29.0 | 10.8 |
| Invasive Coronary Angiography (%) | 16.1 | 11.3 | 14.1 | 6.6 |
| Accuracy to detect obstructive CAD# | ||||
| True positive (%) | 98.6 | 68.9 | 75.0 | 45.5 |
| False positive (%) | 3.7 | 1.4 | 1.3 | 0.5 |
| Coronary Revascularization | ||||
| PCI (%) | 4.3 | 3.0 | 3.3 | 2.1 |
| CABG (%) | 0.9 | 0.7 | 0.7 | 0.5 |
| Cost of Care ($) | ||||
| Diagnostic costs (incl. angiography) | 2,692 | 2,501 | 2,535 | 1,891 |
| Treatment costs | 1,798 | 1,643 | 1,529 | 622 |
| Total | 4,490 | 4,144 | 4,064 | 2,513 |
CCTA = Coronary Computed Tomographic Angiography; ECHO = Echocardiography; ETT = Exercise Tolerance Test; PCI = Percutaneous Coronary Intervention; SPECT = Single-Photon Emission Computed Tomography.
*
The outcomes were based on a simulation of each strategy in 1000 patients from ROMICAT II trial, #estimated based on published diagnostic accuracy data for each test