{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T02:46:42Z","timestamp":1793069202456,"version":"4.5.0"},"reference-count":28,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T00:00:00Z","timestamp":1686096000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010983","name":"Health Research Fund of Central Denmark Region","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010983","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002739","name":"Aarhus University Research foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002739","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Clinical likelihood (CL) models are designed based on a reference of coronary stenosis in patients with suspected obstructive coronary artery disease. However, a reference standard for myocardial perfusion defects (MPDs) could be more appropriate. We aimed to investigate the ability of the 2019 European Society of Cardiology pre-test probability (ESC-PTP), the risk-factor-weighted (RF-CL) model, and coronary artery calcium score-weighted (CACS-CL) model to diagnose MPDs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Symptomatic stable de novo chest pain patients (n = 3374) underwent coronary computed tomography angiography and subsequent myocardial perfusion imaging by single-photon emission computed tomography, positron emission tomography, or cardiac magnetic resonance. For all modalities, MPD was defined as coronary computed tomography angiography with suspected stenosis and stress-perfusion abnormality in \u22652 segments. The ESC-PTP was calculated based on age, sex, and symptom typicality, and the RF-CL and CACS-CL additionally included a number of risk factors and CACS. In total, 219\/3374 (6.5%) patients had an MPD. Both the RF-CL and the CACS-CL classified substantially more patients to low CL (&amp;lt;5%) of obstructive coronary artery disease compared with the ESC-PTP (32.5 and 54.1 vs. 12.0%, P &amp;lt; 0.001) with preserved low prevalences of MPD (&amp;lt;2% for all models). Compared with the ESC-PTP [area under the receiver-operating characteristic curve (AUC) 0.74 (0.71\u20130.78)], the discrimination of having an MPD was higher for the CACS-CL model [AUC 0.88 (0.86\u20130.91), P &amp;lt; 0.001], while it was similar for the RF-CL model [AUC 0.73 (0.70\u20130.76), P = 0.32].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Compared with basic CL models, the RF-CL and CACS-CL models improve down classification of patients to a very low-risk group with a low prevalence of MPD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjci\/jead135","type":"journal-article","created":{"date-parts":[[2023,6,7]],"date-time":"2023-06-07T19:33:15Z","timestamp":1686166395000},"page":"39-47","source":"Crossref","is-referenced-by-count":8,"title":["Diagnostic performance of clinical likelihood models of obstructive coronary artery disease to predict myocardial perfusion defects"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2790-2608","authenticated-orcid":false,"given":"Laust Dupont","family":"Rasmussen","sequence":"first","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup Hospital , Hospitalsparken 15, Herning DK-7400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line Emilie Br\u00f8gger","family":"Albertsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup Hospital , Hospitalsparken 15, Herning DK-7400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5885-9537","authenticated-orcid":false,"given":"Louise","family":"Nissen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup Hospital , Hospitalsparken 15, Herning DK-7400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"June Anita","family":"Ejlersen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Viborg Hospital , Viborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christin","family":"Isaksen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital , Silkeborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore","family":"Murphy","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, Barts Health NHS Trust , West Smithfield, London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne Maare","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Regional Hospital Central Jutland , Viborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Kirk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Regional Hospital Central Jutland , Silkeborg , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lau","family":"Brix","sequence":"additional","affiliation":[{"name":"Department of Radiology, Diagnostic Centre, University Research Clinic for Innovative Patient Pathways, Silkeborg Regional Hospital , Silkeborg , Denmark"},{"name":"Department of Clinical Medicine, Comparative Medicine Lab, Aarhus University , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0144-1305","authenticated-orcid":false,"given":"Lars Christian","family":"Gormsen","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET Centre, Aarhus University Hospital , Aarhus , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4622-5160","authenticated-orcid":false,"given":"Steffen E","family":"Petersen","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, St Bartholomew\u2019s Hospital, Barts Health NHS Trust , West Smithfield, London , UK"},{"name":"William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University London , Charterhouse Square, London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2116-2370","authenticated-orcid":false,"given":"Morten","family":"B\u00f8ttcher","sequence":"additional","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup Hospital , Hospitalsparken 15, Herning DK-7400 , Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Winther","sequence":"additional","affiliation":[{"name":"Department of Cardiology, G\u00f8dstrup Hospital , 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