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Patrick G. O’Malley, MD, MPH

Arch Intern Med. 2006;166:1071-1072.

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

I disagree with Dr Raggi on the strength of evidence supporting the practice of routine screening for subclinical atherosclerosis among asymptomatic individuals. The principal differences in interpretation of the data are 2-fold: (1) I believe that there is insufficient measurement of risk factors in most of the available prospective cohort studies against which the new information is compared, and (2) I believe that most of the multivariate analyses are inadequate to assess the true independent prognostic value of this new information.

I agree that there is exciting evidence emerging, but at this time there are significant gaps in knowledge on the prognostic value, the association with improved outcomes, and cost-effectiveness. Clinicians simply cannot provide adequate information (based on the available evidence) for patients to make truly informed decisions about the probability of appreciably refining one's future risk for cardiovascular disease based on this testing. Regarding . . . [Full Text of this Article]