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Updated: Dec 27, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

745

Comparison of the CAD consortium and updated Diamond-Forrester scores for predicting obstructive coronary artery

Un Woo Lee1, Shin Ahn1, Yo Sep Shin1

  • 1Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

The American Journal of Emergency Medicine
|March 7, 2020
PubMed

Insights

The Coronary Artery Disease (CAD) Consortium models better predict obstructive CAD in emergency department patients than the Diamond-Forrester (DF) method. The Consortium models excel at identifying low-risk patients, while the DF model is better for high-risk cases.

Area of Science:

  • Cardiology
  • Medical Diagnostics
  • Public Health

Background:

  • Current guidelines recommend Diamond-Forrester (DF) and Coronary Artery Disease (CAD) Consortium models for obstructive CAD risk assessment.
  • Accurate pretest probability assessment is crucial for managing patients with chest pain in emergency departments.

Purpose of the Study:

  • To compare the performance of the DF method and CAD Consortium models in predicting obstructive CAD.
  • To evaluate model accuracy in a real-world emergency department setting for chest pain patients.

Main Methods:

  • A comparative study involving 1247 chest pain patients evaluated in an emergency department.
  • Coronary computed tomographic angiography (CTA) was used to assess for obstructive CAD.
  • Invasive angiography was used for confirmation when clinically indicated.

Main Results:

  • Obstructive CAD was diagnosed in 34.2% of patients.
  • The CAD Consortium clinical model showed the highest area under the receiver-operating curve (0.754), outperforming the basic Consortium model (0.736) and the DF model (0.718).
  • CAD Consortium models improved classification of low-risk patients, while the DF model better identified high-risk patients.

Conclusions:

  • The CAD Consortium clinical model demonstrates improved prediction for low-risk patients (<15% probability of obstructive CAD) compared to the DF model.
  • Caution is advised when applying the CAD Consortium clinical model to high-risk populations.
  • Both CAD Consortium models showed significant net reclassification improvement over the DF model.
Abstract

Keywords:
Chest painCoronary artery diseaseEmergency departmentPretest probabilityRisk assessment

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