To the Editor In an Original Investigation published in a recent issue of JAMA Internal Medicine, Foy et al¹ computed that to avoid 1 myocardial infarction (MI), 250 people need to have coronary computed tomographic angiography (CCTA) instead of functional testing. They also computed that for every 37 people scanned by CCTA, there will be 1 excess revascularization procedure. Foy et al “…hypothesize that at least some of these additional procedures are associated with the finding of incidental CAD that is not causing symptomatic ischemia and would not have been detected with functional stress testing alone.”^1(p1630) They refer to the contentious issue of overdiagnosis and overtreatment, most notably observed in the breast cancer screening debate.²

致编辑在最新一期的《JAMA内科杂志》上发表的原始调查中，Foy等人¹计算出要避免1例心肌梗塞（MI），需要250人进行冠状动脉计算机断层造影（CCTA）而不是功能检查。他们还计算出，通过CCTA扫描的每37个人中，将有1个多余的血运重建程序。Foy等人“……假设这些附加程序中至少有一些与发现偶然的CAD有关，而偶然的CAD不会导致症状性缺血，仅通过功能性压力测试就无法检测到。” ^{1 （p1630）}他们提到了过度诊断和过度治疗的争议性问题，在乳腺癌筛查辩论中最为明显。^2个