Overview
The 2024 European Society of Cardiology (ESC) guidelines recommend a more structured way to estimate the likelihood of obstructive coronary artery disease (CAD) in people with suspected chronic coronary syndromes. A major feature of this approach is the risk factor-weighted clinical likelihood model, or RF-CL model. It is designed to improve the initial pre-test probability estimate, helping clinicians decide who should undergo further testing, who may need invasive coronary angiography, and who may safely avoid unnecessary investigations.
This Great Debate article examines both sides of the argument: why the RF-CL model is useful in real-world practice, and why some experts remain cautious about its limitations. The discussion matters because estimating disease likelihood is the first step in the modern diagnostic pathway for stable chest pain and related symptoms.
