New data showing that the slightly more than one-third of patients with previously unconfirmed coronary artery disease who go to the cath lab for invasive angiography testing actually have an obstructive blockage are sure to ratchet up the already active discussions around the appropriate use of cardiac imaging - both from the effectiveness and safety perspectives. Part of the solution may be the development of molecular IVD tests aimed at triaging patients to imaging. Even if slow to integrate this brand of R&D into their development strategies, some makers of in vivo imaging equipment are beginning to realize this.

Buoyed by their success with Genomic Health, a trio of West Coast VCs have expanded their portfolios of molecular diagnostic companies, with many following similar themes. CardioDx has developed a test to distinguish between patients who should move on to cardiac imaging and those they are comfortable managing otherwise. Such a rule-out test is a challenging proposition. But if adopted, and more broadly, as molecular diagnostics move into new and broad markets like cardiology and metabolic disease, pharma could use this opportunity to its advantage in many settings, including co-marketing arrangements.

A look back at the biggest devices stories of the decade, in capsule form.