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. 2011 Dec 7;2011(12):CD008691. doi: 10.1002/14651858.CD008691.pub2

Marwick 1990.

Clinical features and settings Clinical features
  • ESKD patients undergoing coronary angiography as part of transplant workup with longstanding diabetes, history of chest pain or previous MI, or age > 40


Setting
  • Cleveland Clinic, Ohio, USA

Participants
  • Number: 45

  • DM: 51%

  • Angina pectoris or IHD: 33%

  • Hypertension: 81%

  • Sex: 71% male


Exclusion criteria
  • Recent angina or MI

Study design Cohort study
Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
  • Each angiogram was independently assessed by a reviewer blinded to fluorographic results.

  • CAD was defined as presence of ≥ 1 coronary arteries with ≥ 70% diameter stenosis.

Index and comparator tests Dipyridamole SPECT Thallium Imaging
  • Images were displayed using a semi‐quantitative system with a segmented colour scale. Scans were interpreted by an experienced observer without knowledge of catheterisation results, and were classified into groups with normal perfusion, fixed defect or reversible defect.

Follow‐up Follow up over 25 ± 14 months.
Notes  
Table of Methodological Quality
Item Authors' judgement Description
Representative spectrum? 
 All tests Yes ESKD patients undergoing cardiac evaluation as part of transplant workup.
Acceptable reference standard? 
 All tests Yes Coronary angiography with a reference standard threshold of ≥ 70% stenosis.
Acceptable delay between tests? 
 All tests Yes Thallium scanning was performed within a week of coronary angiography.
Partial verification avoided? 
 All tests Yes All participants who received an index test received the reference standard test.
Differential verification avoided? 
 All tests Yes Disease status (CAD) diagnosed by coronary angiography.
Incorporation avoided? 
 All tests Yes Disease status (CAD) diagnosed by coronary angiography.
Reference standard results blinded? 
 All tests Yes Author correspondence.
Index test results blinded? 
 All tests Yes Author correspondence.
Relevant clinical information? 
 All tests Yes Relevant clinical information was provided regarding performance and analysis of the index and reference tests.
Uninterpretable results reported? 
 All tests Yes No results were reported to be uninterpretable.
Withdrawals explained? 
 All tests Yes No withdrawals were reported.