This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Computed Tomography  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic

Is the Sales Cart Before the Evidence Horse?

Patrick G. O’Malley, MD, MPH

Arch Intern Med. 2006;166:1065-1068.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Although appealing, screening for subclinical vascular disease remains a controversial topic. In addition to exercise stress testing, which I will not discuss herein, atherosclerosis detection technologies are available as a potential means to refine risk prediction. Such procedures include computed tomography for coronary calcification, ultrasound for carotid intima media thickness, ankle-brachial index, and brachial artery reactivity. They are expensive, induce further expensive testing, and their use is burgeoning despite what I believe is insufficient evidence to support such practice. I present an argument that opposes the practice of screening for atherosclerosis in asymptomatic individuals at this time, consistent with the US Preventive Services Task Force review that there is insufficient evidence to support its routine use.¹

It is intuitive to feel that somehow we need to do more, and do more earlier in the disease process, to better combat the menace of atherosclerotic disease. The . . . [Full Text of this Article]

DOES THE TEST PROVIDE ADDITIVE PROGNOSTIC INFORMATION?

IS THE USE OF THE TEST ASSOCIATED WITH IMPROVED OUTCOMES?

IS THERE EVIDENCE THAT THE TEST IS COST-EFFECTIVE IN ASYMPTOMATIC POPULATIONS?

AUTHOR INFORMATION