Mon, 07/30/2012 – 17:34 — traine

This may seem like a bit of a cop out, but I hope not. I put the ROMICAT II study on the reading list last week, but I think the topic needs a bit more exploration.  As pointed out by EM Lit of Note here, there are now 3 high quality ED based studies on the use of CCTA to help us rule out ACS in low risk patients – ROMICAT II, CT STAT, and ACRIN PA. [Note: if you think we should explore others in this forum, please let me know so I can link to them.]

While there seems to be utility in clearing these pts from the ED earlier than our traditional method (still one of the best and most efficient in the world – seriously), the evidence indicates that we may be robbing Peter to pay Paul (higher downstream testing/consultations/costs, plus the radiation issue minimal though it may be).

Are we using this test in the most effective manner possible, or is CCTA still a test in search of its proper cohort as suggested by the ROMICAT II Editorial?