The influence of bias on the subjective interpretation of cardiac angiograms

Diamond, George A.; Vas, Ran; Forrester, James S.; Xiang, Hu; Whiting, James S.; Pfaff, Martin; Swan, H. J. C.

doi:10.1016/0002-8703(84)90135-2

Cited by 16 publications

(2 citation statements)

References 17 publications

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“…This required review of the complete medical records of each potential candidate for inclusion to confirm the MI and rule out any previous MIs not coded in the REP database. A definitive diagnosis of MI was based on previously published recommendations for the diagnosis of MI [62][63][64] and relied on documented chest pain, elevated enzyme levels and abnormal ECGs 65 (Table 1). Troponin was not included in the definition of MI because it was not available or used routinely in this setting until 2000, and its use could, therefore, introduce temporal bias.…”

Section: Data Collectionmentioning

confidence: 99%

Identification of Women's Coronary Heart Disease and Risk Factors Prior to First Myocardial Infarction

Yawn

Wollan

Jacobsen

et al. 2004

Journal of Women's Health

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Section: Data Collectionmentioning

confidence: 99%

Identification of Women's Coronary Heart Disease and Risk Factors Prior to First Myocardial Infarction

Yawn

Wollan

Jacobsen

et al. 2004

Journal of Women's Health

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“…[17,61,62] We chose to use these very specific research criteria to assure that patients had experienced an AMI. [5,62] Each potentially eligible patient's medical record was reviewed by a trained cardiac research nurse abstracter to assure that it met the criteria for AMI and then rechecked by one of the authors (VR).…”

Section: Methodsmentioning

confidence: 99%

The gender specific frequency of risk factor and CHD diagnoses prior to incident MI: A community study

et al. 2007

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Accuracy of subjective and computer‐assisted assessments of angiographic left ventricular regional wall motion

Kussmaul

Kleaveland

Zeevi

et al. 1990

Cathet. Cardiovasc. Diagn.

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To evaluate the accuracy of angiographic methods for analysis of left ventricular regional wall motion, we measured the ability of a carefully performed subjective analysis (three independent observers) and that of three computer-assisted methods (centerline, radial, and area) to detect the presence of significant coronary artery disease. Normal ranges were established in 90 studies showing normal wall motion, and accuracy was tested in a second, consecutive series of 43 ventriculograms. The results show that the subjective method best separated those regions with from those without significant coronary disease. The subjective method also demonstrated sensitivity comparable to the centerline and radial methods. Among the computer-assisted methods, the area method was least sensitive but most specific for both anterior and inferior region coronary disease. The centerline and radial methods were highly sensitive, but less specific. When coronary disease was defined by electrocardiographic Q-waves, the area method had superior accuracy. Further analysis showed the following: 1) For the centerline and radial methods, long-axis reregistration of the end-systolic frame resulted in loss of sensitivity but increased specificity for anterior wall coronary disease, and little change in analysis of the inferior wall; 2) inclusion or exclusion of the apex had little effect on predictive accuracy for anterior wall coronary disease; 3) as expected, sensitivity and specificity results of all methods were dependent on the selection of a normal range cutoff value; but when performance was optimized, the subjective and area methods had a higher overall predictive accuracy than the centerline method; 4) It is likely that all three computer-assisted methods could be calibrated to give indications of degrees of hypokinesis, as their results correlated well with subjective observers' evaluations over the entire range of scores. These results should assist in selection of the optimal method for regional wall motion analysis in clinical and research applications. As currently applied, the area method is the most specific of the computer-assisted methods tested; the centerline and radial methods have highest sensitivity and therefore are most suited to detection of mild degrees of hypokinesis.

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The influence of bias on the subjective interpretation of cardiac angiograms

Cited by 16 publications

References 17 publications

Identification of Women's Coronary Heart Disease and Risk Factors Prior to First Myocardial Infarction

Identification of Women's Coronary Heart Disease and Risk Factors Prior to First Myocardial Infarction

The gender specific frequency of risk factor and CHD diagnoses prior to incident MI: A community study

Accuracy of subjective and computer‐assisted assessments of angiographic left ventricular regional wall motion

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