Twenty two studies were included in the meta-analysis. A total of 1,331 patients and 10,561 segments were analysed. The percentage of patients excluded from studies after CT angiography ranged from 0 to 13.5 per cent. The percentage of non-evaluable proximal segments ranged from 0 to 15.4 per cent and for distal segments from 0 to 19.3 per cent.
Patient level data: The pooled estimate of sensitivity was 97.7 per cent (95% CI: 96.2%, 98.7%), I2 = 0.0% and specificity was 91.0% (95%CI: 88.5, 93.1%), I2 = 23.4%. If non-evaluable CT angiography investigations were included, specificity was reduced significantly if non-evaluable participants were classified as having significant coronary artery stenosis; sensitivity was reduced significantly if they were classified as not having significant stenosis. Regression analyses indicated that the prevalence of coronary artery stenosis did not significantly affect sensitivity, but that there was a significant negative correlation between heart rate and sensitivity.
Segment level data: The overall pooled estimate of sensitivity was 90.8 per cent (95% CI: 89.0, 92.4%), I2 = 86.2% and specificity was 95.7 per cent (95% CI: 95.2, 96.1%), I2 = 93.0%. For proximal segments, sensitivity was 94.2 per cent (95% CI: 92.3, 95.7%), I2 = 56.0%, and specificity 94.1% (95% CI: 93.4, 94.8%), I2 = 89.7%. For distal segments, sensitivity was 84.8% (95% CI: 81.1, 88.0%), I2 = 85.0 and specificity 96.9% (95% CI: 96.4, 97.4%), I2 = 86.0%. Sensitivity was significantly higher and specificity significantly lower in proximal compared with distal segments (p < 0.05).
Further data were reported for specific arterial segments.