In any case, recently, because discussions within the cardiology community over the EBT have come to be based more on data and less on feelings, those discussions have become much less polarized, and much more objective.
On July 1, 2000, the American Heart Association and the American College of Cardiology released an updated “expert consensus” on the EBT. The authors of this report included both strong proponents of the EBT, and skeptics. The authors reviewed all the available published studies, and concluded the following (note that in this statement the EBT is referred to as the electron beam CT scan, or the EBCT):
“Although preliminary data are intriguing with respect to risk prediction in the asymptomatic patient, available data are insufficient to support recommending EBCT to asymptomatic members of the general public or for routine clinical use. Further studies are enthusiastically recommended for determining the additive predictive effect of the calcium score in patients with intermediate risk, particularly in the elderly. The use of EBCT in selected asymptomatic patients can be justified when performed in the context of a medical assessment only after the more standard cardiac risk assessment is considered insufficient by the physician to direct further therapy plans.”
In other words, the joint statement concluded that routine use of the EBT for screening members of the general public who do not have symptoms of coronary artery disease cannot yet be justified by the available data. The bone that was thrown to proponents of the EBT was an “enthusiastic recommendation” for further study. While not really satisfying to anybody, such a statement is felt to be a step forward from the fervent endorsements and the angry denunciations of a few years ago. We still do not know exactly what to do with EBTs, but at least we can be collegial about it.
