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Previous Volume 339:2018-2020 December 31, 1998 Number 27 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Electron-beam computed tomography (CT) is a new, increasingly widely promoted technique for the detection of calcification within coronary atherosclerotic lesions. Evidence supporting the use of this test in screening for coronary artery disease is gradually accumulating, but there is considerable controversy about the role of electron-beam CT in identifying patients at risk for cardiovascular events.^1,2 Despite the controversy among experts, centers performing electron-beam CT advertise for and generate business on the basis of patients' referring themselves for the test. Is electron-beam CT ready for widespread use through the mechanism of self-referral? This question can be answered only after proper consideration . . . [Full Text of this Article]

The Growth of Electron-Beam CT

Patient Self-Referral for Electron-Beam CT

The Hidden Costs of Electron-Beam CT

The Risks of Self-Referral for Electron-Beam CT

Summary

Address reprint requests to Dr. Taylor at the Cardiology Service, Walter Reed Army Medical Center, Bldg. 2, Rm. 4A, Washington, DC 20307-5001.

References

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• Doherty, T. M., Fitzpatrick, L. A., Inoue, D., Qiao, J.-H., Fishbein, M. C., Detrano, R. C., Shah, P. K., Rajavashisth, T. B. (2004). Molecular, Endocrine, and Genetic Mechanisms of Arterial Calcification. Endocr. Rev. 25: 629-672 [Abstract] [Full Text]  
• Fenton, J. J., Deyo, R. A. (2003). Patient Self-Referral for Radiologic Screening Tests: Clinical and Ethical Concerns. J Am Board Fam Med 16: 494-501 [Abstract] [Full Text]  
• Illes, J., Fan, E., Koenig, B. A., Raffin, T. A., Kann, D., Atlas, S. W. (2003). Self-referred Whole-Body CT Imaging: Current Implications for Health Care Consumers. Radiology 228: 346-351 [Abstract] [Full Text]  
• O'Malley, P. G., Feuerstein, I. M., Taylor, A. J. (2003). Impact of Electron Beam Tomography, With or Without Case Management, on Motivation, Behavioral Change, and Cardiovascular Risk Profile: A Randomized Controlled Trial. JAMA 289: 2215-2223 [Abstract] [Full Text]  
• Nallamothu, B. K., Saint, S., Bielak, L. F., Sonnad, S. S., Peyser, P. A., Rubenfire, M., Fendrick, A. M. (2001). Electron-Beam Computed Tomography in the Diagnosis of Coronary Artery Disease: A Meta-analysis. Arch Intern Med 161: 833-838 [Abstract] [Full Text]  
• O'Malley, P. G., Jones, D. L., Feuerstein, I. M., Taylor, A. J. (2000). Lack of Correlation between Psychological Factors and Subclinical Coronary Artery Disease. NEJM 343: 1298-1304 [Abstract] [Full Text]  
• Shaw, L. J., O'Rourke, R. A. (2000). The challenge of improving risk assessment in asymptomatic individuals: the additive prognostic value of electron beam tomography?. J Am Coll Cardiol 36: 1261-1264 [Full Text]  
• Fischer, A., Gutstein, D. E, Fayad, Z. A, Fuster, V. (2000). Predicting plaque rupture: enhancing diagnosis and clinical decision-making in coronary artery disease. Vasc Med 5: 163-172 [Abstract]  
• Goldstein, R. E., Holmboe, E. S. (1999). Prognostic Indicators for Coronary Artery Disease: Ready for the Bedside?. JAMA 281: 565-566 [Full Text]  
• (1999). Electron Beam CT of the Coronary Arteries. JWatch General 1999: 2-2 [Full Text]