Consensus ratings were on a scale of 1–9, with 1–3 being inappropriate, 4–6 being uncertain and 7–9 being appropriate. A total of 16 investigators participated. A Delphi clinical consensus process was used, with ratings by eight participants (four cardiologists, two radiologists, one nuclear medicine physician and one methodologist). A separate development team of eight investigators (one dual cardiologist–radiologist, two radiologists and five methodologists) defined the questions and categories shown in the table but did not participate in the clinical appropriateness rating. aStudies discussed during the meeting showed higher patient acceptance for CT than for SPECT, MRI or invasive testing186,187,188.