What is the most commonly performed imaging test for CAD in the U.K.?
The most common imaging test is #CVnuc, #yesCCT increasing after 2016 NICE CG95 but the treadmill is still the most common test whatever the guidelines say openheart.bmj.com/content/6/2/e0… 
Myocardial perfusion #scintigraphy for the diagnosis and management of CAD was first assessed by NICE in 2003 nice.org.uk/guidance/ta73
And then MPS was incorporated into the CG95 published in 2010 and 2016 nice.org.uk/guidance/CG95
NICE treats all flavours of functional tests as equivalent and makes them 1st line for known CAD patients (and brought back the treadmill in 2016!)
Indeed there was no difference in unnecessary cath rates in this UK multicentre study between #CVnuc and #whyCMR (Noninvasive Functional Imaging Strategies and Unnecessary Angiography Rates ja.ma/3eret62
In Europe assessment includes pre test probability and imaging bearing in mind all test performance is Bayesian (CT for low risk, functional for intermediate and cath for high risk) academic.oup.com/eurheartj/arti…
Provision of cardiac CT has increased over time but unequally around the country openheart.bmj.com/content/6/2/e0…
Over the same time frame there has been an increase in all non-invasive imaging and an increase in purely diagnostic caths and static numbers of revasc procedures (PCI & CABG).
The Richards report outlined the constraints facing NHS imaging (and other diagnostic) services before and after coronavirus england.nhs.uk/wp-content/upl…
So there no current or projected capacity for one modality to replace the others and usage depends on local availability and expertise
The increase in purely diagnostic caths means that the alternative gatekeeper tests are not working or being utilised as they should. Should invasive angiography be performed as ?proceed
Moreover as 40% of cardiac CTs are normal, going forward we better pretest prediction to reduce unecessary testing openheart.bmj.com/content/8/1/e0…
To optimise the usage of finite resources to better serve our patients
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