What's behind the Ratings for heart screening tests?

Last reviewed: February 2011

We rated 10 medical tests that screen for cardiovascular disease. We focused on their effectiveness, benefits, and value for people without symptoms of the disease. The Rating for each screening test can differ depending on a person's age, gender, and overall risk of developing cardiovascular disease.

We chose these 10 because they are commonly available and the evidence for each had been previously reviewed by the U.S. Preventive Services Task Force, an independent group supported by the U.S. Department of Health and Human Services that develops recommendations on preventive health care, including screening tests. For each test, we evaluated five factors, which together gave a potential total score of 100 points.

1. U.S. Preventive Services Task Force grade

The panel reviewed the scientific evidence on each test and assigned it a grade, which we then used in our Ratings, as shown below:

Task Force Grade What the Grade Means Points in our Ratings
A Screening is strongly recommended. 50
B Screening is recommended. 30
C Screening is generally not recommended, though it may be appropriate for certain individuals or circumstances. 20
D Screening is not recommended. 0
I There is insufficient evidence to make a screening recommendation. 10
2. Additional evidence

We assigned up to 10 points if we found substantial additional evidence about a test's effectiveness beyond what was considered by the task force. Because screening tests that received an A grade from the panel already have substantial support, we did not look for additional evidence.

3. Disease burden

We assigned up to 20 points based on the number of people likely affected by the form of cardiovascular disease potentially detected by the test.

4. Value

We assigned up to 20 points depending on a test's value, as determined by these three components:

  • The cost of the test itself, mainly from HealthcareBlueBook.com (up to 6 points).
  • The cost of treating the disease if it's detected, based on a likely treatment plan with lifestyle changes, prescription medication, and in some cases, surgery or other procedures (up to 6 points). Drug-cost estimates came from our Best Buy Drugs reports. Other treatment costs generally came from HealthcareBlueBook.com.
  • Cost effectiveness based on independent analyses of the likely improvement in a patient's quality of life from being tested and treated (up to 8 points).
5. Additional benefits

We assigned up to 10 points if we determined that a test offered additional health benefits beyond its cardiovascular ones.

The total score for each test was converted to our Ratings, as shown below.

Points Rating What the Rating means
81-100 The benefits very likely outweigh the risks.
61-80 The benefits likely outweigh the risks.
41-60 It's uncertain whether the benefits outweigh the risks.
21-40 The benefits are unlikely to outweigh the risks.
0-20 The benefits are very unlikely to outweigh the risks.
This project was made possible in part by a grant from the New York State Attorney General on behalf of Attorneys General of all 50 states, the District of Columbia, and Puerto Rico, from litigation-settlement funds to benefit the health-care needs of consumers with high blood pressure and angina.
 
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