Comments on: Editor’s and Fellow’s Journal Club Choices, Oct 2008 http://www.ajnrblog.org/2009/01/23/editors-and-fellows-journal-club-choices-oct-2008/ American Journal of Neuroradiology Sun, 08 Jan 2012 03:41:31 +0000 hourly 1 By: Blaise Jones http://www.ajnrblog.org/2009/01/23/editors-and-fellows-journal-club-choices-oct-2008/comment-page-1/#comment-13 Blaise Jones Mon, 02 Feb 2009 14:26:41 +0000 http://www.ajnrblog.org/?p=182#comment-13 I have always had problems with the assumption of catheter angiography as the "gold standard". By definition, gold standards cannot be assessed for true accuracy, as they are considered de facto correct. In peds, the logistical barriers to performing catheter angiography make less invasive techniques very atrractive, increasing their use. With this in mind, it has been my experience that the confidence level for the diagnosis of traumatic cervical artery injury is greater wtih CTA than with catheter angio or MRA. I would even be interested in seeing the results of a study that evaluated catheter angio for cervical dissection with the assumption that CTA was the gold standard, rather than the more typical inverse approach. Can anybody explain to me why we must always consider the catheter study to be the cats pajamas? I have always had problems with the assumption of catheter angiography as the “gold standard”. By definition, gold standards cannot be assessed for true accuracy, as they are considered de facto correct. In peds, the logistical barriers to performing catheter angiography make less invasive techniques very atrractive, increasing their use. With this in mind, it has been my experience that the confidence level for the diagnosis of traumatic cervical artery injury is greater wtih CTA than with catheter angio or MRA.

I would even be interested in seeing the results of a study that evaluated catheter angio for cervical dissection with the assumption that CTA was the gold standard, rather than the more typical inverse approach. Can anybody explain to me why we must always consider the catheter study to be the cats pajamas?

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