Table BFinal ranking of Future Research Needs for noninvasive technologies for the diagnosis of CAD in women

TierQuestionScore
Top TierWhat is the impact of NIT modalities on outcomes beyond diagnostic accuracy (risk stratification, prognostic information, treatment decisions, and clinical outcomes)?14
Are women getting the same diagnostic testing as men? Are men over-tested and/or women under-tested?*10
What is the comparative accuracy in real-world settings? (most of the studies were single center, best-quality/high expertise centers)8
Does the comparative accuracy of NITs in women vary based on the pretest probability of CAD of the women undergoing the test? How does the pretest probability of CAD impact the findings on clinical decisionmaking?7
What is the comparative effect of NIT modalities on utilization, further testing, and impact on cost?*6
Does the comparative accuracy of NITs in women vary based on patient risk profiles?5
Is there a sequential order in which NITs should be used for evaluating CAD ( i.e., multiple testing or layered-testing strategies)?*5
Middle TierWhat is the comparative safety and accuracy of functional vs. anatomic NIT modalities?4
What is the comparative safety and accuracy of functional NIT testing strategies with and without imaging?4
How would a better understanding of provider diagnostic ordering patterns and understanding of appropriate use guidelines to support evidence-based decisionmaking impact the use of NITs?*3
Does the comparative accuracy of NITs in women vary based on differing symptomology and timing at presentation?2
Does the comparative accuracy of NITs in women vary based on racial/ethnicity differences?2
What is the value of performing a specific NIT test for the diagnosis of CAD in women, compared with no testing?*2
Does clinician preference, availability, or setting (outpatient vs. chest pain unit of an emergency department) impact NIT use?*2
Lower TierDoes the comparative accuracy of NITs in women vary based on different settings (outpatient, inpatient, emergency room)?*1
Does the comparative accuracy of NITs in women vary based on: body size, heart size, menopausal status, functional status, stress modality?1
How does patient preference of testing factor into decisionmaking?*1
Does the comparative accuracy of NITs in women vary based on age?0
What are the potential harms of NITs?0

CAD = coronary artery disease; NIT = noninvasive technology

*

Out-of-scope research topics are highlighted in italics.

From: Executive Summary

Cover of Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women: Future Research Needs
Noninvasive Technologies for the Diagnosis of Coronary Artery Disease in Women: Future Research Needs: Identification of Future Research Needs From Comparative Effectiveness Review No. 58 [Internet].
Future Research Needs Papers, No. 41.
Sanders GD, Patel MR, Chatterjee R, et al.

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