In other words, following the Heart Association's method to identify potential future victims of heart disease, we will mis-diagnose, mis-classify, overlook, and simply fail a great many-no, most-people with hidden heart disease.

Why 48%? That's the number I arrive at when I ask: How many men and women have CT heart scan scores above zero representing measurable coronary atherosclerotic plaque?

The enormous difference between the 7.5% of Americans with crystal-clear, life-threatening heart disease and the 48% who have coronary plaque is the Detection Gap. The Gap is big, encompassing tens of millions of people.

If heart disease is detected by a CT heart scan, it tends to be early, before catastrophe strikes. By the conventional approach to detection of heart disease, in contrast, you often don't know you have it until catastrophe strikes and you're lying on a hospital gurney being wheeled off to a major procedure.

If heart disease is detected by waiting for the appearance of symptoms, then a stress test (usually nuclear) is followed by a heart catheterization, stents, bypass, etc. So there's more than a Detection Gap. There's also a difference in the sorts of therapies chosen. There's certainly a difference in cost: a Health Expense Gap?

In my view, there is no rational reason not to close the Detection Gap. While CT heart scan scores aren't perfect, they're darn close. Heart scans hold potential to shrink the Detection Gap to around 2%. We'd save millions of lives and billions of dollars. If you're one for New Year's resolutions, a heart scan is a great place to start. It's certainly better than a cholesterol test, a stress test, or waiting for something to hit you on the side of the head.