July 2014 Br J Cardiol 2014;21:116 doi:10.5837/bjc.2014.025
John Whitaker, Andrew Wragg, Khaled Alfakih
Introduction In 2010, the National Institute of Health and Care Excellence (NICE) published a new guideline for the investigation of patients with chest pain of recent onset. This guideline reflected the importance of assessing the pre-test probability (PTP) of finding coronary artery disease (CAD) in patients, prior to selecting further investigations. NICE advocated a modified Duke Clinical Score method to calculate pre-test probability of CAD. They recommended the use of cardiac computed tomography (CT) in the investigation of patients with low PTP of having CAD, alongside clearly defined roles for functional imaging tests, in patients wit
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