Initial Diagnostic Test Research Articles

An Overview on Iron Deficiency Anaemia

"Anaemia’’ is defined as a collection of disorders caused by erythropoietin tissues' incapacity to maintain normal haemoglobin concentration due to insufficient availability of one or more nutrients, which lowers the amount of haemoglobin in circulation overall. It can be brought on by a poor vegetarian diet, iron malabsorption, hookworm infections, profuse bleeding during menstruation, or childbirth.Low birth weight, decreased immunological function, poor cognitive development, behavioural issues, decreased job ability, and maternal mortality are among the negative outcomes of anaemia. The most popular and sensitive initial diagnostic test for IDA is serum ferritin. The most effective methods of treating iron deficiency anaemia include dietary variety, supplementation, fortification of staple foods, and nutrition education. Keywords: Anaemia, iron deficiency, micronutrient deficiency, nutritional anaemia

Interventions and implementation considerations for reducing pre-treatment loss to follow-up in adults with pulmonary tuberculosis: A scoping review

Background Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission. Objectives We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation. Methods We searched eight electronic databases up to February 6 2024, medRxiv for pre-prints, and reference lists of included studies. Two review authors independently selected studies and extracted data using a predesigned form. We analysed data descriptively, presented findings in a narrative summary and developed a conceptual framework based on the Practical, Robust Implementation, and Sustainability Model to map the factors for effective intervention implementation. Results We reviewed 1262 records and included 17 studies. Most studies were randomized controlled trials (8/17, 47%). Intervention barriers included stigma and inadequate resources; enablers included mobile phones and TB testing and results on the same day. We identified eight interventions that reduced PTLFU: treatment support groups; mobile notifications; community health workers; integrated HIV/TB services; Xpert MTB/RIF as the initial diagnostic test; computer-aided detection with chest radiography screening; active linkage to care; and multi-component strategies. Conclusion Given the variation of healthcare settings, TB programs should consider contextual factors such as user acceptability, political commitment, resources, and infrastructure before adopting an intervention. Future research should utilize qualitative study designs, be people-centred, and include social and economic factors affecting PTLFU.

Tuberculosis presenting with multiple osteolytic lesions in an adolescent boy with fanconi anemia

Tuberculosis (TB) is well known to present with varied clinical and radiological features. Multifocal bone involvement in tuberculosis is rare. Multiple lytic lesions raise the possibility of malignancy usually, especially, in children with predisposing conditions like Fanconi anemia. However, a thorough evaluation with repeated attempts at histopathological confirmation and microbiological evaluation is mandatory in children with unique presentations with inconclusive initial diagnostic tests. We report an adolescent boy with an underlying Fanconi anemia who presented with fever, cough and respiratory distress. On evaluation, he had pallor, wasting, features of right upper lobe consolidation and multiple lytic lesions. Initial diagnostic evaluation including bone marrow evaluation and a diagnostic biopsy from ribs and bronchoalveolar lavage failed to yield a conclusive diagnosis. After nearly 5 weeks of broad-spectrum antibiotics and antifungals, as the clinical signs were progressing, a complete re-evaluation including biopsy from the rib lesion was done and further, he was diagnosed to have skeletal tuberculosis based on the Mycobacterium Growth Indicator Tube (MGIT) culture for Acid Fast bacilli (AFB). Child was empirically started on anti-tuberculous therapy pending cultures, which have led to significant clinical improvement in 2 weeks of therapy. Low bacterial load in skeletal TB reduces the chance to diagnosis, hence making clinical judgment imperative in diagnosis; and repeated testing is mandatory when there is high index of suspicion.

Analysis of the Effectiveness of the Teaching at the Right Level (TaRL) Approach in Improving Students' Literacy Skills through the 15-Minute Literacy Program at Primary School

This research aims to analyze the effectiveness of the Teaching at the Right Level (TaRL) approach in improving students' literacy skills through a 15-minute literacy program. This approach is based on grouping students according to their ability levels, allowing teaching strategies to be tailored to students' needs. The method used in this study is descriptive with a qualitative approach, where data is collected through observation, interviews, and documentation. Students are grouped based on their reading abilities: beginner, letters, words, paragraphs, and stories. The instruments used in this study are initial diagnostic and developmental tests conducted orally at the beginning and during the research process. These tests measure the overall development of students' reading skills over time. Data analysis is conducted to evaluate students' engagement and their responses to short but intensive literacy activities. The results indicate a significant improvement in students' literacy skills at all reading ability levels, both in comprehension and reading fluency. This improvement suggests that the TaRL approach can effectively enhance elementary school literacy skills. This research is expected to significantly contribute to developing more effective literacy strategies in elementary schools to optimize short yet effective learning time.

QOL-11. GBM PATIENTS CONTINUE TO FACE BARRIERS TO PERSONALIZED AND COMPREHENSIVE CARE THAT MAY IMPACT LONGEVITY AND QUALITY-OF-LIFE

Abstract We assessed the quality and accessibility of healthcare services provided to Glioblastoma (GBM) patients across the United States through an online survey distributed among the OurBrainBank community and partners and promoted on social media. A total of 297 patients or caregivers completed the survey (85% caregivers; 15% GBM patients). Median age at diagnosis was 57, lower than the national average of 64. 78% of our respondents described having some college education, and 69% had commercial insurance. Preliminary results revealed that 69% were informed about tumor testing. Among those informed, 64% did not have any molecular testing beyond initial diagnostic tests. For all respondents, 65% were not informed about storing tissue for future testing, and 79% reported not having their tissue stored for possible treatments or clinical trial qualification. Additionally, 52% reported no discussion of seeking a second opinion, and 64% reported not being offered enrollment in any clinical trial. Overall, people living with GBM face significant barriers to achieving comprehensive and personalized care. Lack of tumor testing and storage present missed opportunities for future access to emerging therapies that could improve individual outcomes. Over half of patients had no discussion about seeking a second opinion and were not offered enrollment in clinical trials, highlighting significant barriers to accessing life-extending or quality-of-life (QOL) improving treatments. Compared to the general population affected by GBM, survey respondents represented a disproportionately young and urban population, suggesting potential bias in who is able to respond to the survey. This may underestimate the challenges faced by patients with additional barriers. We are implementing strategies to reach a more geographically diverse participant group, particularly in rural areas. Ongoing targeted recruitment will further elucidate barriers to patient-centered care in GBM, with the potential for significant improvements in survival and QOL.

Atypical presentation of falciparum malaria in a returning traveler: a diagnostic dilemma

Falciparum malaria, caused by Plasmodium falciparum, is a significant global health concern, especially in tropical regions. This case report details an atypical presentation of falciparum malaria in a 32-year-old male who returned to India after traveling to South Africa. The patient presented with a two-month history of high-grade fever, severe anemia, jaundice, easy fatigability, and significant weight loss. Initial laboratory investigations revealed severe anemia, thrombocytopenia, elevated inflammatory markers, and splenomegaly, but peripheral blood smears were negative for malaria parasites. Despite initial challenges in diagnosis, bone marrow aspiration confirmed the presence of P. falciparum. The patient was treated with artemether/lumefantrine, resulting in clinical and hematological improvement. This case highlights the importance of considering malaria in patients with unexplained anemia and splenomegaly, especially those with recent travel to endemic areas, even when initial diagnostic tests are negative. It underscores the value of comprehensive diagnostic approaches, including bone marrow examination, in atypical cases. This report contributes to the understanding of malaria's varied clinical presentations and reinforces the need for awareness and timely intervention to prevent complications.

Infertility: A Family Nurse Practitioner Approach in Primary Care

Infertility affects ∼19% of women between the ages of 15 and 49 years, and ∼9% of men of reproductive age in the United States. Rising infertility rates have led to couples presenting with infertility concerns in the primary care setting, emphasizing the nurse practitioner's vital role in beginning the infertility workup. Using an infertility algorithm can aid in the diagnosis and seamless transition to a fertility specialist. The nurse practitioner can obtain a detailed medical and reproductive history, perform an appropriate physical examination, order initial diagnostic testing, perform a medication reconciliation, provide patient education, and initiate referrals to specialists.

Clinical Associations of E148Q Heterozygosity: What to Expect From E148Q?

The exact effects of MEFV variants on inflammation are still under investigation, and reports on variants of unknown significance, particularly the E148Q variant, have been conflicting. Therefore, this study aims to investigate patients exhibiting E148Q heterozygosity, focusing on diagnoses and disease courses to assist physicians in interpreting the variant. Data of pediatric patients presenting to the Pediatric Rheumatology clinic between November 2016 and September 2023, exhibiting only E148Q heterozygosity in MEFV gene analysis, were extracted. Patients who were lost before 9 months of follow-up have been excluded to ensure the completion of initial diagnostic tests and evaluations. Among the 119 patients with E148Q variant, the diagnoses were as follows: healthy, 51.3%; IgA vasculitis, 10.1%; Familial Mediterranean Fever (FMF), 7.6%; Periodic fever, Aphtous stomatitis, Pharyngitis, Adenitis (PFAPA), 6.7%; and other diagnoses, 19.3%. IgA vasculitis patients experienced articular, gastrointestinal, and renal involvement at rates of 91.7%, 58.3%, and 16.7%, respectively. Complete response, partial response, and no response to colchicine were 37.5%, 12.5%, and 50%, respectively, in PFAPA patients. All FMF patients responded to colchicine treatment resulting in reduced mean FMF episode counts in 6 months from 3.22 ± 0.92 to 0.56 ± 0.52. The E148Q variant may amplify inflammation and modify disease courses. Patients with the E148Q variant experiencing typical FMF episodes should receive colchicine, but clinicians should exercise caution regarding alternative diagnoses. Additionally, the E148Q variant may increase acute phase reactants and disease severity in IgA vasculitis. However, to reach definitive conclusions on its treatment-modifying role in PFAPA, universal diagnosis and treatment response criteria should be adopted.

Prospective evaluation of thin-layer agar colour test in routine diagnosis of multidrug-resistant TB.

<sec><title>BACKGROUND</title>This study evaluated the diagnostic performance of the thin-layer agar MDR/XDR-TB Colour Test (CT), a Mycobacterium tuberculosis complex (MTBC) detection and direct drug susceptibility testing (DST) method with routine sputum, bronchoalveolar lavage and pleural fluid specimen.</sec><sec><title>METHODS</title>In a prospective study, the time and rate of MTBC detection were compared between CT, Löwenstein-Jensen, and MGIT media. Times until DST result, sensitivities, and specificities were evaluated between CT and MGIT 960 indirect DST.</sec><sec><title>RESULTS</title>The cultivation of 177 pulmonary specimens resulted in 83 MTBC-positive cultures. The sensitivity of CT for MTBC detection was 81.3% with a median time of 20 days compared to 13 days and 93.5% for MGIT. The sensitivity of CT for DST results was 100% for isoniazid and levofloxacin and 94.7% for rifampicin. The specificities for isoniazid and rifampicin DST were 97.3% and 98.0% for levofloxacin. The median time until a DST result was significantly shorter with CT than the BACTEC MGIT 960 system, 20 and 27 days, respectively, independent of the specimen type used.</sec><sec><title>CONCLUSIONS</title>The CT is a highly accurate and fast initial diagnostic test for high-incidence settings and could also be used as a first culture and direct DST in peripheral settings.</sec>.

Endoscopic Advances in the Diagnosis and Management of Gastroesophageal Reflux Disease.

Gastroesophageal reflux disease (GERD) is one of the most common diseases that occurs secondary to failure of the antireflux barrier system, resulting in the frequent and abnormal reflux of gastric contents to the esophagus. GERD is diagnosed in routine clinical practice based on the classic symptoms of heartburn and regurgitation. However, a subset of patients with atypical symptoms can pose challenges in diagnosing GERD. An esophagogastroduodenoscopy (EGD) is the most common initial diagnostic test used in the assessment for GERD, although half of these patients will not have any positive endoscopic findings suggestive of GERD. The advanced endoscopic techniques have improved the diagnostic yield of GERD diagnosis and its complications, such as Barrett's esophagus and early esophageal adenocarcinoma. These newer endoscopic tools can better detect subtle irregularities in the mucosa and vascular structures. The management options for GERD include lifestyle modifications, pharmacological therapy, and endoscopic and surgical interventions. The latest addition to the armamentarium is the minimally invasive endoscopic interventions in carefully selected patients, including the electrical stimulation of the LES, Antireflux mucosectomy, Radiofrequency therapy, Transoral Incisionless Fundoplication, Endoscopic Full-Thickness plication (GERDx™), and suturing devices. With the emergence of these advanced endoscopic techniques, it is crucial to understand their selection criteria, advantages, and disadvantages.

Imaging in Infective Endocarditis-Current Opinions and Trends in Cardiac Computed Tomography.

Infective endocarditis is a rare disease with an increasing incidence and an unaltered high mortality rate, despite medical development. Imaging plays an integrative part in the diagnosis of infective endocarditis, with echocardiography as the initial diagnostic test. Research data in the utility of cardiac computed tomography (CCT) in the diagnostic algorithm of IE are rising, which indicates its importance in detection of IE-related lesion along with the exclusion of coronary artery disease. The latest 2023 European Society of Cardiology Guidelines in the management of IE classified CCT as class of recommendation I and level of evidence B in detection of both valvular and paravalvular lesions in native and prosthetic valve endocarditis. This review article provides a comprehensive and contemporary review of the role of CCT in the diagnosis of IE, the optimization of acquisition protocols, the morphology characteristics of IE-related lesions, the published data of the diagnostic performance of CCT in comparison to echocardiography as the state-of-art method, as well as the limitations and future possibilities.

Characterization of Heart Diseases per Single Lead Using ECG Images and CNN-2D.

Cardiopathy has become one of the predominant global causes of death. The timely identification of different types of heart diseases significantly diminishes mortality risk and enhances the efficacy of treatment. However, fast and efficient recognition necessitates continuous monitoring, encompassing not only specific clinical conditions but also diverse lifestyles. Consequently, an increasing number of studies are striving to automate and progress in the identification of different cardiopathies. Notably, the assessment of electrocardiograms (ECGs) is crucial, given that it serves as the initial diagnostic test for patients, proving to be both the simplest and the most cost-effective tool. This research employs a customized architecture of Convolutional Neural Network (CNN) to forecast heart diseases by analyzing the images of both three bands of electrodes and of each single electrode signal of the ECG derived from four distinct patient categories, representing three heart-related conditions as well as a spectrum of healthy controls. The analyses are conducted on a real dataset, providing noteworthy performance (recall greater than 80% for the majority of the considered diseases and sometimes even equal to 100%) as well as a certain degree of interpretability thanks to the understanding of the importance a band of electrodes or even a single ECG electrode can have in detecting a specific heart-related pathology.

The Google Form and Microsoft Excel applications: Non-Cognitive Initial Diagnostic Test Instrument for Guidance and Counseling Teachers

This research is motivated by the lack of effectiveness and efficiency of the implementation of the distribution of non-cognitive initial diagnostic tests conducted by Guidance and Counseling teachers. The very long time allocation makes many Guidance and Counseling teachers unwilling to carry out the initial non-cognitive diagnostic test because it requires up time for other student assistance services. The Non-Cognitive Initial Diagnostic Test is very important to do as student learning profiling, which can be used as initial data in conducting differentiated learning. This study aims to determine the effectiveness and efficiency of the use of Google Forms and Ms Excel applications as non-cognitive initial diagnostic test instruments for Guidance and Counseling teachers. The type of research is descriptive qualitative. Data collection uses observation, interviews and documentation studies. Data validity techniques using triangulation techniques. The results of research use the Five Stages method, namely the Preliminary Research Stage, Model Development Stage, Model Validation Stage, Effectiveness Test Stage, and Dissemination Stage. Google Forms and Ms. Excel have ease of operation, distribution, data processing and accessibility. Google Forms and Ms. Excel a very appropriate combinations of applications for conducting non-cognitive diagnostic tests, because of their effectiveness efficiency and operation.

Non‐linear nexus of mineral rents, coal rents, foreign direct investment, and environmental sustainability: Importance of institutional quality in E‐7 nations

AbstractThis study investigates the impact of natural resources (NRs), economic growth (GDP), institutional quality, mining and coal rents, and foreign direct investment (FDI) on the environmental quality in the E‐7 countries (Brazil, China, India, Indonesia, Russia, Turkey, and Mexico) from 1990 to 2021. To do this, such advanced estimation methods are used as the method of moments quantile regression (MMQR), with the artificial neural network utilized for robustness checks. The initial diagnostic test results unveiled the presence of cross‐sectional dependence, slope heterogeneity, and long‐run cointegration. The MMQR analysis results indicate that coal and mineral rents escalate environmental pollution by reducing the load capacity factor (LCF) across all quantiles. The results further indicate that FDI and economic growth negatively affect while institutional quality (INS) significantly promotes the LCF in E‐7 countries. Moreover, INS significantly moderates the relationship between mineral resources and LCF, as well as coal resources and LCF. The robustness test also validates these findings. Based on these results, policy measures aimed at strengthening institutional quality, particularly within the NR sector, are crucial for mitigating the adverse impacts of coal and mineral extraction on LCF and promoting sustainable development in the E‐7 countries.

Pathological Variables and Laboratory Values in Infants with Neonatal Cholestasis Showing Nonexcretion on Tc-99m Mebrofenin Hepatobiliary Scans: A Descriptive Study.

Cholescintigraphy using Tc-99m Mebrofenin is routinely performed as an initial diagnostic test in infants with neonatal cholestasis suspected of having biliary atresia. Demonstration of drainage of bile into the small intestine indicates patency of the biliary tract and thus rules out biliary atresia. Non-excretion of tracer into the small intestine, however, can be caused by obstructive as well as non-obstructive conditions, and it is known that false-positive findings are found with the use of Tc-99m Mebrofenin scintigraphy. In the present study, we retrospectively calculated the proportion of infants eventually diagnosed to have biliary atresia that were initially ruled to have a non-excreting cholescintigraphy pattern in our institution. We have also attempted a systematic description of the cardinal histological characteristics, haematological and hepatic biochemical variables in infants with non-excreting patterns. This retrospective, descriptive study was conducted in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry. We reviewed data from infants who underwent cholescintigraphy with Tc-99m Mebrofenin between January 2016 through June 2022. We included infants in whom the scan was ruled "non-excreting" i.e. those infants in whom biliary atresia could not be ruled out based on the results of the scan. The difference in mean for haematological parameters and ALP were compared between the two groups i.e., biliary atresia versus other than biliary atresia by using Independent student's t-test; the remaining liver biochemical parameters were compared by using Mann-Whitney U Test and a p value < 0.05 was considered to be statistically significant. A non-excretory pattern on cholescintigraphy was found to be due to biliary atresia in 49% of cases (as confirmed by exploratory surgery) and an additional 19.6 % of cases by trucut biopsy (total 68.6%). The difference in the mean serum GGT levels was found to be statistically significant (<0.001). A non-draining pattern on cholescintigraphy is caused by biliary atresia in the greater percentage of cases presenting with cholestasis. The difference in mean GGT levels was found to be statistically significant between biliary atresia and other causes of non-draining patterns on cholescintigraphy.

Imaging Innovations in the Screening, Diagnosis, and Monitoring of Systemic Autoimmune Disease-Related Interstitial Lung Disease

Interstitial lung disease (ILD) is a common and serious complication of systemic autoimmune rheumatic diseases (SARD). The prevalence and prognosis of ILD vary depending on the type and severity of the underlying SARD. Recently, two drugs have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of ILD in SARD, and the American College of Rheumatology (ACR) has issued guidelines for the screening and monitoring of these patients. Therefore, it is essential to detect and manage ILD in SARDs as early as possible. High-resolution CT of the chest is the current gold standard test for diagnosis of ILD, yet, it is not uniformly performed as an initial diagnostic test. This review discusses the latest advances in imaging techniques for the diagnosis, assessment, and follow-up of SARD-ILDs.

Description of Bronchial Wash (BW) as a diagnostic procedure for presumptive pulmonary tuberculosis with sputum scarce at Mataram Regional Hospital

Background: Some patients with presumptive TB cannot be bacteriologically confirmed because sputum is scarce. Improvement in the diagnostic value of using bronchoscopy for specimen collection has been reported. Due to its high sensitivity and specificity, PCR examination is recommended as an initial diagnostic test in all individuals suspected of pulmonary TB. This study aims to describe the results of the BW examination using the PCR GeneXpert MTB/RIF test in these populations treated at Mataram Regional General Hospital. Methods: A descriptive study with secondary data collection from medical records at Mataram Regional General Hospital was conducted from July to December 2023. Statistical analysis was carried out using SPSS 26. Data on age, gender, examination results, and rifampicin sensitivity levels were described as proportions. Results: A total of 143 patients were included in the analysis. Gender males (61.5%) and those aged 40-60 years (44.8%) were reported in this study. Of this examination, 89 (61.5%) patients reported positive, 52 (37.1%) negative, and 2 errors (1.4%). Based on the level of cycle threshold, it was reported that 16 patients (17.9%) were high, 12 patients (13.5%) were medium, 21 patients (23.6%) were low, and 40 patients (44.9%) were very low. No rifampicin resistance was reported in this study. Conclusion: More than 50% of presumptive pulmonary TB patients with sputum scarce were reported positive through the BW and GeneXpert MTB/RIF examinations. This examination is recommended especially for these populations to get faster antituberculosis treatment.

Design and validation of initial diagnostic tests for preservice teachers as a tool for teacher education effectiveness

ABSTRACT Teacher education quality and effectiveness have been at the centre of policy discussions in the last decades. As part of efforts to improve teacher preparation, law 20.903 requires Chilean universities to design and apply diagnostic tests assessing the construct of their choice to all first-year preservice teachers. Based on these results, universities must design strategies to support their students. However, universities are facing challenges in implementing these tests, primarily due to the complexity, time and cost associated with developing high-quality tests. In collaboration with three universities, we developed three diagnostic tests: Social Thinking Test, Attitudes Towards Diversity Questionnaire, and Mathematics test for Teaching in Primary Education. Unlike many of the tests currently used by universities, these instruments were specifically designed to measure core teaching skills and attitudes defined by the national standards for Chilean teachers. To collect validity and reliability evidence, the tests were piloted with over 850 Chilean preservice teachers. Reliability was analysed using Cronbach’s alpha, with results ranging between 0.67 and 0.92. Validity was examined based on content and internal structure evidence. The analysis of content evidence indicated good coverage of the target domains as defined by the assessment frameworks, and internal structure results point towards the presence of multidimensionality in two of the three tests. This paper discusses the results of these pilot studies and how diagnostic tests that are constructed and analysed from the perspective of the standards (American Educational Research Association, American Psychological Association y National Council on Measurement in Education, 2014) can provide valuable information to improve the effectiveness of teaching education.

Performance of CBNAAT on Pleural Biopsies Obtained by Semirigid Thoracoscopy for Diagnosis of Unexplained Pleural Effusion: A Prospective Study from North India.

Exudative pleural effusions are commonly encountered in clinical practice, but in about one-fourth of cases, etiology remains elusive after initial evaluation. Medical thoracoscopy with semirigid thoracoscope is a minimally invasive procedure with high diagnostic yield for diagnosing pleural diseases, especially these undiagnosed exudative pleural effusions. In tubercular endemic areas, often, these effusions turn out to be tubercular, but the diagnosis of tubercular pleural effusion is quite challenging due to the paucibacillary nature of the disease. Although culture is the gold standard, it is time-consuming. Cartridge-based nucleic acid amplification test (CBNAAT) is a novel rapid diagnostic test for tuberculosis (TB) and has been recommended as the initial diagnostic test in patients suspected of having extrapulmonary TB (EPTB). We conducted a prospective observational study of 50 patients with undiagnosed pleural effusion admitted to our tertiary care hospital. The primary aim of the study is to evaluate the diagnostic performance of CBNAAT on thoracoscopic guided pleural biopsy and compare it with conventional diagnostic techniques like histopathology and conventional culture. Of 50 undiagnosed pleural effusions, TB (50%) was the most common etiology. The overall diagnostic yield of semirigid thoracoscopy in this study was 74%. Our study showed that CBNAAT of pleural biopsies had a sensitivity of 36% only but a specificity of 100%. The sensitivity of CBNAAT was not far superior to the conventional culture. Tuberculosis (TB) is a common cause of undiagnosed pleural effusion in our set-up. CBNAAT testing of pleural biopsy, though, is a poor rule-out test for pleural TB, but it may aid in the early diagnosis of such patients.

Role of non-invasive coronary imaging in stable angina.

Chest pain represents a symptom of significant clinical concern due to the potential for lethal etiologies. Accordingly, it is critical to ascertain the presence of stable angina through various diagnostic tests to inform subsequent therapeutic strategies. Stable angina, while potentially progressing to more severe conditions if left untreated, suffers from a paucity of research regarding its management compared to other more fatal causes of chest pain. Recent advancements in radiological imaging necessitate a re-evaluation of the array and functionality of diagnostic tests, with particular emphasis on prioritizing non-invasive methods such as electrocardiography and echocardiography. This study undertakes a comprehensive review of the literature pertaining to various diagnostic tests for stable angina. We conclude that the management of a patient presenting with chest pain encompasses a continuum of care, beginning with a detailed patient history to estimate pre-test probability and culminating in computed tomography coronary angiography. This continuum is highly individualized, taking into account patient-specific variables, disease burden, and test indications. In an era of rapid research advancement, our findings delineate the optimal sequence of initial diagnostic tests, emphasizing the role of current non-invasive imaging modalities as outlined in standard clinical guidelines.