Change in k=2 before-and-after Risk of bias: 0 71.5% of patients LGE-CMR was found to Very low management case series had a change in influence what treatment Inconsistency: –1 ⨁⨀⨀⨀ management after patients received, but it is No comparative LGE-CMR (change unknown how this differs Indirectness: –1 studies in invasive from what they would Imprecision: –1 procedure in have received due to the 24.2%). comparators. Publication bias: 0 3/9 CABGs were averted due to non-viability, and overall 13% had a change in surgical management plan. a GRADE Working Group grades of evidence () High quality: We are very confident that the true effect lies close to that of the estimate of effect. ⨁⨁⨁⨁ Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the ⨁⨁⨁⨀ estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from ⨁⨁⨀⨀ the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially ⨁⨀⨀⨀ different from the estimate of effect. AE = adverse event; CABG = coronary artery bypass; CT-DCE = computed tomography perfusion with delayed contrast enhancement; DbE = low-dose dobutamine Echo; Echo = echocardiography; k = number of studies; LGE-CMR = late gadolinium enhancement with cardiac magnetic resonance imaging; RCT = randomised controlled trial; SPECT = emission computed tomography; Tl = thallium-201; Tm = technetium-99m
Change in management k=2 before-and-after case series No comparative studies Risk of bias: 0 Inconsistency: –1 Indirectness: –1 Imprecision: –1 Publication bias: 0 71.5% of patients had a change in management after LGE-CMR (change in invasive procedure in 24.2%). 3/9 CABGs were averted due to non-viability, and overall 13% had a change in surgical management plan. LGE-CMR was found to influence what treatment patients received, but it is unknown how this differs from what they would have received due to the comparators. Very low ⨁⨀⨀⨀ a GRADE Working Group grades of evidence () ⨁⨁⨁⨁ High quality: We are very confident that the true effect lies close to that of the estimate of effect. ⨁⨁⨁⨀ Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. ⨁⨁⨀⨀ Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. ⨁⨀⨀⨀ Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect. AE = adverse event; CABG = coronary artery bypass; CT-DCE = computed tomography perfusion with delayed contrast enhancement; DbE = low-dose dobutamine Echo; Echo = echocardiography; k = number of studies; LGE-CMR = late gadolinium enhancement with cardiac magnetic resonance imaging; RCT = randomised controlled trial; SPECT = emission computed tomography; Tl = thallium-201; Tm = technetium-99m
1237-AssessmentReport-Final.docx