Figure 6.

External validation and performance of ASSIST. Application of the ASSIST tool in both the unmatched and matched subpopulation of SCOT-HEART used for external validation purposes confirmed that concordance (vs. disagreement) between the ASSIST-proposed best initial diagnostic strategy and a patient allocation to anatomical-first imaging vs. standard of care (which included functional-first testing) was associated with a reduction in the risk of the study primary composite endpoint (A–C), as well as the harmonized composite endpoint of all-cause mortality and non-fatal myocardial infarction (D and E). ASSIST, Anatomical vs. Stress teSting decIsion Support Tool; SCOT-HEART, Scottish COmputed Tomography of the HEART Trial.