The Quantitative Science of Evaluating Imaging Evidence

Tessa S.S. Genders, Bart S. Ferket, M. G.Myriam Hunink

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Cardiovascular diagnostic imaging tests are increasingly used in everyday clinical practice, but are often imperfect, just like any other diagnostic test. The performance of a cardiovascular diagnostic imaging test is usually expressed in terms of sensitivity and specificity compared with the reference standard (gold standard) for diagnosing the disease. However, evidence-based application of a diagnostic test also requires knowledge about the pre-test probability of disease, the benefit of making a correct diagnosis, the harm caused by false-positive imaging test results, and potential adverse effects of performing the test itself. To assist in clinical decision making regarding appropriate use of cardiovascular diagnostic imaging tests, we reviewed quantitative concepts related to diagnostic performance (e.g., sensitivity, specificity, predictive values, likelihood ratios), as well as possible biases and solutions in diagnostic performance studies, Bayesian principles, and the threshold approach to decision making.

Original languageEnglish
Pages (from-to)264-275
Number of pages12
JournalJACC: Cardiovascular Imaging
Issue number3
StatePublished - 1 Mar 2017


  • cardiovascular diagnostic imaging
  • coronary artery disease
  • diagnostic performance


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