Parameters for diagnostic strategies
| Parameter | Mean value (95% CI) | Source | Comments/distribution |
|---|---|---|---|
| Accuracy of diagnostic devices | |||
| Primary analysis | |||
| CA—sensitivity | 1 | Assumed | |
| CA—specificity | 1 | Assumed | |
| Probability ETT inconclusive given CHD | 0.215686 (0.163 to 0.270) | CE-MARC11 | Non-parametric bootstrap |
| Probability ETT inconclusive given no CHD | 0.40694 (0.352 to 0.460) | CE-MARC11 | Non-parametric bootstrap |
| ETT—sensitivity (inconclusive treated as positive) | 0.9755 (0.953 to 0.995) | CE-MARC11 | Non-parametric bootstrap |
| ETT—specificity (inconclusive treated as positive) | 0.1924 (0.152 to 0.239) | CE-MARC11 | Non-parametric bootstrap |
| ETT—sensitivity (excluding inconclusive) | 0.9688 (0.941 to 0.994) | CE-MARC11 | Non-parametric bootstrap |
| ETT—specificity (excluding inconclusive) | 0.3245 (0.260 to 0.396) | CE-MARC11 | Non-parametric bootstrap |
| CMR—sensitivity | 0.8627 (0.821 to 0.903) | CE-MARC11 | Non-parametric bootstrap |
| CMR—specificity | 0.8312 (0.792 to 0.868) | CE-MARC11 | Non-parametric bootstrap |
| CMR—sensitivity given ETT positive/uncertain | 0.8643 (0.817 to 0.907) | CE-MARC11 | Non-parametric bootstrap |
| CMR—specificity given ETT positive/uncertain | 0.8633 (0.817 to 0.903) | CE-MARC11 | Non-parametric bootstrap |
| SPECT—sensitivity (inconclusive treated as positive) | 0.6784 (0.623 to 0.736) | CE-MARC11 | Non-parametric bootstrap |
| SPECT—specificity (inconclusive treated as positive) | 0.7980 (0.760 to 0.836) | CE-MARC11 | Non-parametric bootstrap |
| SPECT—sensitivity given ETT positive/uncertain (inconclusive treated as positive) | 0.6784 (0.613 to 0.743) | CE-MARC11 | Non-parametric bootstrap |
| SPECT—specificity given ETT positive/uncertain (inconclusive treated as positive) | 0.7969 (0.750 to 0.847) | CE-MARC11 | Non-parametric bootstrap |
| Mortality rates | |||
| CA mortality | 0.0007 | West 200617 | Fixed |
| PCI mortality | 0.001281 (0.0009 to 0.0017) | BCIS16 | β-Distribution |
| CABG mortality | 0.007914 (0.0066 to 0.0094) | SCS15 | β-Distribution |
| Procedure costs | |||
| ETT cost—base case | £75 | NHS reference costs22 | Fixed value |
| CMR cost—base case | £313 | NICE costing document23 | Fixed value |
| SPECT cost—base case | £293 | NICE costing document23 | Fixed value |
| CA cost | £1052 | NHS reference costs22 | Fixed value |
| PCI cost | £2657 | NHS reference costs22 | Fixed value |
| CABG cost | £8635 | NHS reference costs22 | Fixed value |
| Other | |||
| Proportion of patients with severe stenosis eligible for PCI | 0.6276 (0.623 to 0.632) | BCIS and SCS15 16 | β-Distribution |
| Proportion of patients with severe stenosis | 0.3947 (0.360 to 0.434) | CE-MARC11 | β-Distribution |
| Proportion of patients without severe stenosis but with angina | 0.159 | CE-MARC11 | Fixed value |
BCIS, British Cardiovascular Intervention Society; CA, coronary angiography; CABG, coronary artery bypass grafting; CHD, coronary heart disease; CMR, cardiovascular magnetic resonance; ETT, exercise treadmill testing; NHS, National Health Service; NICE, National Institute for Health and Clinical Excellence; PCI, percutaneous coronary intervention; SCS, The Society for Cardiothoracic Surgery in Great Britain & Ireland; SPECT, single-photon emission CT.