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Coronary artery disease (CAD) is the leading cause of death globally. The accurate diagnosis of CAD is important to clinical decision making and patient care with the goal of reducing both morbidity and mortality. Cardiac computed tomography (CCT) is a new noninvasive imaging modality which has been recently adopted into clinical practice. Many contemporary guidelines have endorsed CCT as a first line test for patients with suspected CAD. Fryback and Thornbury proposed a six-tiered model outlining goals when investigating and establishing a new diagnostic tool into clinical care. These tiers include technical efficacy, diagnostic accuracy efficacy, diagnostic thinking efficacy, therapeutic efficacy, patient outcome efficacy and societal efficacy. This thesis summarizes the research that has contributed to CCT's global acceptance. The eight papers demonstrate how CCT satisfies the requirements of the Fryback model (accuracy, ability to risk stratify patients, guide therapeutic decision making and its impact on costeffectiveness). These peer-reviewed publications have transitioned CCT into clinical practice.