Nearly $7 billion is spent each year in the U.S. on diagnostic testing of the estimated three million people with symptoms of obstructive coronary artery disease (CAD). A new blood test that detects specific genes activated in individuals with obstructive CAD could exclude the diagnosis without the need for imaging studies or more invasive tests, reducing health care costs, as described in an article in Population Health Management, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The article is available on the Population Health Management website.

Louis Hochheiser (St. John's Medical Center, Jackson, WY), Jessie Juusola and Mark Monane (CardioDx, Palo Alto, CA), and Joseph Ladapo (New York University School of Medicine, NY), use a decision analysis model to compare the cost-effectiveness of "usual care" for obstructive CAD diagnosis with a strategy that includes "gene expression score (GES)-directed care." They present the results and potential value of this new diagnostic approach in the article "Economic Utility of a Blood-Based Genomic Test for the Assessment of Patients with Symptoms Suggestive of Obstructive Coronary Artery Disease."

"Work like this is vital to our understanding as we move from a world of volume to value," says Editor-in-Chief David B. Nash, MD, MBA, Dean and Dr. Raymond C. and Doris N. Grandon Professor, Jefferson School of Population Health, Philadelphia, PA.