Angiogram accuracy

PA <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

I had an angiogram last month which showed a 70% occlusion
in the mid LAD, at least according to the doctor who did it.

Giving the CDROM to a second cardiologist he said that "the
occlusion is probably below 70%". A third one "felt the
occlusion is much less". He even put the CDROM in a "new
digital machine that estimates accurately and independent
from the observer". The outcome was a 53% occlusion estimation!

Well, what is the truth?

You got three different opinions.

The truth is that you have coronary disease that is occlusive enough
to cause symptoms.

Quoted message said:

Are these discrepancies justified?

As justified as opinions.

Quoted message said:

Is there really a computer to do the estimation 'accurately'
and independent of the human factor?

A human presumably wrote the program. The greatest source of error is
picking the "normal" area to call 0% (no atheroclerosis). The programs
that I am familiar with still require the operator pick out the place
to call 0% which will be compared to the blockage that is of interest.

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com

Dr. Andrew B. Chung said:

PA <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

I had an angiogram last month which showed a 70% occlusion
in the mid LAD, at least according to the doctor who did it.

Giving the CDROM to a second cardiologist he said that "the
occlusion is probably below 70%". A third one "felt the
occlusion is much less". He even put the CDROM in a "new
digital machine that estimates accurately and independent
from the observer". The outcome was a 53% occlusion estimation!

Well, what is the truth?

Quoted message said:

You got three different opinions.

Quoted message said:

The truth is that you have coronary disease that is occlusive enough
to cause symptoms.

Quoted message said:

Quoted message said:

Are these discrepancies justified?

Quoted message said:

As justified as opinions.

Quoted message said:

Quoted message said:

Is there really a computer to do the estimation 'accurately'
and independent of the human factor?

Quoted message said:

A human presumably wrote the program. The greatest source of error is
picking the "normal" area to call 0% (no atheroclerosis). The programs
that I am familiar with still require the operator pick out the place
to call 0% which will be compared to the blockage that is of interest.

Does the program integrate images taken from various angles?

A plaque may build on on side of a vessel, and so depending on the
angle of the x-ray it will appear more or less narrowing.

Does any software integrate calcium density measurement with
angiogram?

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Why did you have the angiogram in the first place?

Colin Rose MD

PA said:

I had an angiogram last month which showed a 70% occlusion
in the mid LAD, at least according to the doctor who did it.

Giving the CDROM to a second cardiologist he said that "the
occlusion is probably below 70%". A third one "felt the
occlusion is much less". He even put the CDROM in a "new
digital machine that estimates accurately and independent
from the observer". The outcome was a 53% occlusion estimation!

Well, what is the truth? Are these discrepancies justified?
Is there really a computer to do the estimation 'accurately'
and independent of the human factor?

Thanks,
Pete

Dr. Andrew B. Chung said:

Brian Sandle <[email hidden]> wrote in message news:<[email hidden]>...

Quoted message said:

Quoted message said:

A plaque may build on on side of a vessel, and so depending on the
angle of the x-ray it will appear more or less narrowing.

Quoted message said:

Correct.

Quoted message said:

Does any software integrate calcium density measurement with
angiogram?

Quoted message said:

No.

From ask.com

CORONARY ANGIOGRAMS
CORONARY ANGIOGRAMS. APPENDIX X. READING CORONARY ANGIOGRAMS - A
PRIMER. This short course is designed to orient you to read coronary
angiograms.
From:ctcc.cpmc.columbia.edu/cabgpatch/opman/app10.html

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