September 2019 Br J Cardiol 2019;26:105–9 doi:10.5837/bjc.2019.029
Paul Brady, Andrew Kelion, Tom Hyde, Edward Barnes, Hazim Rahbi, Andy Beale, Steve Ramcharitar
Abstract
Introduction
In 2010, the UK’s National Institute for Health and Care Excellence (NICE) published a landmark guideline for the investigation of patients with chest pain of recent onset (CG95). This placed a major emphasis on determining the pre-test probability of coronary artery disease (CAD) and then using this information to select an appropriate imaging test, the exact choice depending to some extent on local expertise.1
In November 2016, NICE published an update of CG95, and made substantial changes to the guidelines. As well as eliminating the clinically derived pre-test probability as a means of directing further investigations, NICE
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