 From 112009 to 3312015 the investigative team introduced and operated a CCTA Chest Pain triage program for low to intermediate risk patients at Stony Brook University Hospital ED and non-emergency outpatient services, the only tertiary care hospital in Suffolk County, New York NY. Concurrently, the investigators established a registry to monitor patient outcomes for all patients receiving CCTA at Stony Brook Medicine. The registry contained nearly 15,000 patient CCTA procedures. The major registry study established the effectiveness of CCTA as an imaging modality for evaluating ED chest pain in a cost efficient manner with a false negative rate less than 1 5. However, the registry reflects the poorer positive predictive values documented by other industry studies 6-8. 