Great debate: the new risk factor-weighted clinical likelihood model is useful to estimate the initial pre-test probability of obstructive coronary artery disease in individuals with suspected chronic coronary syndromes
European Heart Journal
This 'Great debate' article discusses the pros and cons of the new 'risk-factor-weighted clinical likelihood model'. This model was developed to assess patients with suspected chronic coronary syndrome after history taking.
There are several strengths of the model: first, the model includes widely available cardiovascular risk factors to improve estimation of the pre-test clinical likelihood of obstructive coronary artery disease; second, it is simple and easy to use which potentially increases clinical application and third, it identifies a relevant proportion of patients in whom further investigations can be referred.
On the other hand, the model has some important limitations: first, the generalisability of the model is limited given its derivation in a European cohort from Denmark, and second, the model is unable to assess the likelihood of microvascular dysfunction.
