Technical, economic, interpretative, and outcomes issues regarding utilization of cardiac imaging techniques in patients with known or suspected coronary artery disease

In this article, the technical and economic issues that determine the utilization of tests used for cardiac imaging in patients with known or suspected coronary artery disease are discussed. The interpretative and outcomes issues that should determine the utilization of such tests are also discussed. In this regard, special emphasis is placed on, among other issues, the level of training and competence, the pretest probability of disease, the incremental value of a test in the context of what is already known about a patient, and whether risk stratification is justified when risk management is not possible.