Diagnosis of obstructive coronary artery disease using computed tomography angiography in patients with stable chest pain depending on clinical probability and in clinically important subgroups: meta-analysis of individual patient data

OBJECTIVE: To determine whether coronary computed tomography angiography (CTA) should be performed in patients with any clinical probability of coronary artery disease (CAD), and whether the diagnostic performance differs between subgroups of patients. DESIGN: Prospectively designed meta-analysis of individual patient data from prospective diagnostic accuracy studies. DATA SOURCES: Medline, Embase, and Web of Science for published studies. Unpublished studies were identified via direct contact with participating investigators. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective diagnostic accuracy studies that compared coronary CTA with coronary angiography as the reference standard, using at least a 50% diameter reduction as a cutoff value for obstructive CAD. All patients needed to have a clinical indication for coronary angiography due to suspected CAD, and both tests had to be performed in all patients. Results had to be provided using 2×2 or 3×2 cross tabulations for the comparison of CTA with coronary angiography. Primary outcomes were the positive and negative predictive values of CTA as a function of clinical pretest probability of obstructive CAD, analysed by a generalised linear mixed model; calculations were performed including and excluding non-diagnostic CTA results. The no-treat/treat threshold model was used to determine the range of appropriate pretest probabilities for CTA. The threshold model was based on obtained post-test probabilities of less than 15% in case of negative CTA and above 50% in case of positive CTA. Sex, angina pectoris type, age, and number of computed tomography detector rows were used as clinical variables to analyse the diagnostic performance in relevant subgroups. RESULTS: Individual patient data from 5332 patients from 65 prospective diagnostic accuracy studies were retrieved. For a pretest probability range of 7-67%, the treat threshold of more than 50% and the no-treat threshold of less than 15% post-test probability were obtained using CTA. At a pretest probability of 7%, the positive predictive value of CTA was 50.9% (95% confidence interval 43.3% to 57.7%) and the negative predictive value of CTA was 97.8% (96.4% to 98.7%); corresponding values at a pretest probability of 67% were 82.7% (78.3% to 86.2%) and 85.0% (80.2% to 88.9%), respectively. The overall sensitivity of CTA was 95.2% (92.6% to 96.9%) and the specificity was 79.2% (74.9% to 82.9%). CTA using more than 64 detector rows was associated with a higher empirical sensitivity than CTA using up to 64 rows (93.4% v 86.5%, P=0.002) and specificity (84.4% v 72.6%, P<0.001). The area under the receiver-operating-characteristic curve for CTA was 0.897 (0.889 to 0.906), and the diagnostic performance of CTA was slightly lower in women than in with men (area under the curve 0.874 (0.858 to 0.890) v 0.907 (0.897 to 0.916), P<0.001). The diagnostic performance of CTA was slightly lower in patients older than 75 (0.864 (0.834 to 0.894), P=0.018 v all other age groups) and was not significantly influenced by angina pectoris type (typical angina 0.895 (0.873 to 0.917), atypical angina 0.898 (0.884 to 0.913), non-anginal chest pain 0.884 (0.870 to 0.899), other chest discomfort 0.915 (0.897 to 0.934)). CONCLUSIONS: In a no-treat/treat threshold model, the diagnosis of obstructive CAD using coronary CTA in patients with stable chest pain was most accurate when the clinical pretest probability was between 7% and 67%. Performance of CTA was not influenced by the angina pectoris type and was slightly higher in men and lower in older patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42012002780

Measurements of differential cross sections of Z/gamma*+jets+X events in proton anti-proton collisions at sqrt{s}=1.96 TeV

We present cross section measurements for Z/gamma*+jets+X production, differential in the transverse momenta of the three leading jets. The data sample was collected with the D0 detector at the Fermilab Tevatron proton anti-proton collider at a center-of-mass energy of 1.96 TeV and corresponds to an integrated luminosity of 1 fb-1. Leading and next-to-leading order perturbative QCD predictions are compared with the measurements, and agreement is found within the theoretical and experimental uncertainties. We also make comparisons with the predictions of four event generators. Two parton-shower-based generators show significant shape and normalization differences with respect to the data. In contrast, two generators combining tree-level matrix elements with a parton shower give a reasonable description of the the shapes observed in data, but the predicted normalizations show significant differences with respect to the data, reflecting large scale uncertainties. For specific choices of scales, the normalizations for either generator can be made to agree with the measurements.Comment: Published in PLB. 11 pages, 3 figure

Search for resonant diphoton production with the D0 detector

We present a search for a narrow resonance in the inclusive diphoton final state using 2.7 fb-1 of data collected with the D0 detector at the Fermilab Tevatron ppbar Collider. We observe good agreement between the data and the background prediction, and set the first 95% C.L. upper limits on the production cross section times the branching ratio for decay into a pair of photons for resonance masses between 100 and 150 GeV. This search is also interpreted in the context of several models of electroweak symmetry breaking with a Higgs boson decaying into two photons.Comment: 7 pages, 3 figures

Search for charged Higgs bosons decaying to top and bottom quarks in ppbar collisions

We describe a search for production of a charged Higgs boson, q \bar{q'} -> H^+, reconstructed in the t\bar{b} final state in the mass range 180 <= M_{H^+} <= 300 GeV. The search was undertaken at the Fermilab Tevatron collider with a center-of-mass energy sqrt{s} = 1.96 TeV and uses 0.9 fb^{-1} of data collected with the D0 detector. We find no evidence for charged Higgs boson production and set upper limits on the production cross section in the Types I, II and III two-Higgs-doublet models (2HDMs). An excluded region in the (M_{H^+},tan\beta) plane for Type I 2HDM is presented.Comment: Submitted to Phys. Rev. Letter

Search for right-handed W bosons in top quark decay

We present a measurement of the fraction f+ of right-handed W bosons produced in top quark decays, based on a candidate sample of $t\bar{t}$ events in the lepton+jets decay mode. These data correspond to an integrated luminosity of 230pb^-1, collected by the DO detector at the Fermilab Tevatron $p\bar{p}$ Collider at sqrt(s)=1.96 TeV. We use a constrained fit to reconstruct the kinematics of the $t\bar{t}$ and decay products, which allows for the measurement of the leptonic decay angle $\theta^*$ for each event. By comparing the $\cos\theta^*$ distribution from the data with those for the expected background and signal for various values of f+, we find f+=0.00+-0.13(stat)+-0.07(syst). This measurement is consistent with the standard model prediction of f+=3.6x10^-4.Comment: Submitted to Physical Review D Rapid Communications 7 pages, 3 figure

Measurement of the t-channel single top quark production cross section

The D0 collaboration reports direct evidence for electroweak production of single top quarks through the t-channel exchange of a virtual W boson. This is the first analysis to isolate an individual single top quark production channel. We select events containing an isolated electron or muon, missing transverse energy, and two, three or four jets from 2.3 fb^-1 of ppbar collisions at the Fermilab Tevatron Collider. One or two of the jets are identified as containing a b hadron. We combine three multivariate techniques optimized for the t-channel process to measure the t- and s-channel cross sections simultaneously. We measure cross sections of 3.14 +0.94 -0.80 pb for the t-channel and 1.05 +-0.81 pb for the s-channel. The measured t-channel result is found to have a significance of 4.8 standard deviations and is consistent with the standard model prediction.Comment: 7 pages, 6 figure

Observation of ZZ production in ppbar collisions at sqrt(s) = 1.96 TeV

We present an observation for ZZ -> l+l-l'+l'- (l, l' = e or mu) production in ppbar collisions at a center-of-mass energy of sqrt(s) = 1.96 TeV. Using 1.7 fb-1 of data collected by the D0 experiment at the Fermilab Tevatron Collider, we observe three candidate events with an expected background of 0.14 +0.03 -0.02 events. The significance of this observation is 5.3 standard deviations. The combination of D0 results in this channel, as well as in ZZ -> l+l-nunubar, yields a significance of 5.7 standard deviations and a combined cross section of sigma(ZZ) = 1.60 +/- 0.63 (stat.) +0.16 -0.17 (syst.) pb.Comment: 7 pages, 1 figure, 2 tables Modified slightly following review proces

A search for the standard model Higgs boson in the missing energy and acoplanar b-jet topology at sqrt(s) = 1.96 TeV

We report a search for the standard model Higgs boson in the missing energy and acoplanar b-jet topology, using an integrated luminosity of 0.93 inverse femtobarn recorded by the D0 detector at the Fermilab Tevatron Collider. The analysis includes signal contributions from pp->ZH->nu nu b b, as well as from WH production in which the charged lepton from the W boson decay is undetected. Neural networks are used to separate signal from background. In the absence of a signal, we set limits on the cross section of pp->VH times the branching ratio of H->bb at the 95% C.L. of 2.6 - 2.3 pb, for Higgs boson masses in the range 105 - 135 GeV, where V=W,Z. The corresponding expected limits range from 2.8 pb - 2.0 pb.Comment: Submitted to Phys. Rev. Letter

Search for Large extra spatial dimensions in the dielectron and diphoton channels in ppˉ\bm{p\bar{p}} collisions at s=\bm{\sqrt{s}=}1.96 TeV

We report on a search for large extra spatial dimensions in the dielectron and diphoton channels using a data sample of 1.05 \invfb of \ppb collisions at a center-of-mass energy of 1.96 TeV collected by the D0 detector at the Fermilab Tevatron Collider. The invariant mass spectrum of the data agrees well with the prediction of the standard model. We find 95% C.L. lower limits on the effective Planck scale between 2.1 and 1.3 TeV for 2 to 7 extra dimensions.Comment: 7 pages, 3 figures, 3 tables, submitted to Phys. Rev. Let

Search for charged massive long-lived particles with the D0 detector

We search for charged massive long-lived particles using 1.1 fb$^{-1}$ of data collected by the D0 detector at the Fermilab Tevatron $p\bar{p}$ Collider. Time-of-flight information is used to search for pair produced long-lived tau sleptons, gaugino-like charginos, and higgsino-like charginos. We find no evidence of a signal and set 95% C.L. cross section upper limits for staus, which vary from 0.31pb to 0.04pb for stau masses between 60 GeV and 300 GeV. We also set lower mass limits of 206 GeV (171 GeV) for pair produced charged gauginos (higgsinos).Comment: To be submitted to Phys. Rev. Letters, V2: updated the figures and references, V3: final version submitted to PRL and changes in title and abstracts from "stable" to "long-lived