目的 探討冠狀動脈鈣化檢測聯合動態心電圖對冠心病的診斷價值及臨床應用。 方法 對2010年5月－2011年8月住院的108例擬診冠心病的患者同期進行128排螺旋CT冠狀動脈鈣化積分檢測、動態心電圖和冠狀動脈造影，對比研究冠狀動脈鈣化檢測聯合動態心電圖預測冠心病的價值。 結果 冠狀動脈鈣化陽性預測冠心病的靈敏度、特異度、陽性預測值和陰性預測值分別為75.6%、81.0%、73.9%、82.3%；動態心電圖陽性預測冠心病的靈敏度、特異度、陽性預測值和陰性預測值分別為73.3%、76.2%、68.8%、80.0%；冠狀動脈鈣化檢測聯合動態心電圖的系列實驗的特異度和陽性預測值分別達到96.8%和92.9%，平行試驗的靈敏度和陰性預測值分別達到93.3%和92.7%，均顯著高于單項試驗的相應指標（P＜0.05）。 結論 高分辨率螺旋CT冠狀動脈鈣化檢測聯合動態心電圖顯著提高冠心病的診斷價值，可作為老年患者及基層醫院冠心病首選的篩選檢查。
The Institute for Clinical and Economic Review (ICER) has long been committed to promoting fair pricing and equitable access in U.S. healthcare, and has developed a value assessment framework to guide this work. ICER’s value assessment framework was first conceived in 2015 and subsequently updated in 2017 and 2020. This study introduces the ICER value assessment framework (2023). It focuses on elucidating the major revisions within three key areas: cost-effectiveness analysis, health technology assessment (HTA) methods related to health equity and patient engagement, and discusses these changes in light of their central methodological implications. The aim is to provide informative insights and methodological references that may be of value for the development and refinement of HTA practices in China.