Clinical evaluation of the appropriateness use criteria for single-photon emission-computed tomography: differences by patient population, physician specialty, and patient outcomes.

ISRN Cardiology
Regina S DruzGulru Sharifova

Abstract

Objectives. Determine outcome of the 2005 appropriateness use criteria (AUC) for SPECT in a diverse population of patients and physicians. Background. AUC for SPECT were the first cardiology document to identify 52 clinical indications for imaging, 49 of them for stress SPECT. AUC have been proposed as cornerstone of responsible use of perfusion imaging. Methods. 585 consecutive patients undergoing SPECT were evaluated prospectively. Appropriateness was examined for demographic variables, clinical variables, and for physician and patient subgroups. Combined end-point of total mortality, cardiac revascularization, and cardiac admissions at 1 year post SPECT was evaluated. Results. SPECT indications were: appropriate, 63%; uncertain, 20%; inappropriate, 14%; not assigned, 3%. Most appropriate SPECT were observed in patients with known coronary disease (72%), chest pain syndrome (89%), high pre-test likelihood of disease (100%), men (70%), inpatients (72%), and cardiovascular physicians' referrals (69%). End-point was reached in 53 patients (97.4% follow up). Unadjusted event rates were: appropriate (12%), uncertain (7.1%), inappropriate (2.4%) SPECT (P = .01). Conclusion. Appropriateness of SPECT differs in subgroups of patients ...Continue Reading

References

Oct 18, 2005·Journal of the American College of Cardiology·Manesh R PatelUNKNOWN American College of Cardiology Foundation
Nov 21, 2007·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·R Parker WardUNKNOWN American Society of Nuclear Cardiology
Jan 20, 2009·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Daniel S BermanGuido Germano

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Citations

May 31, 2014·The American Journal of Cardiology·Marcio S BittencourtRon Blankstein
Mar 19, 2014·European Journal of Nuclear Medicine and Molecular Imaging·G MedolagoUNKNOWN Italian Working Group of Nuclear Cardiology
Feb 28, 2015·Journal of the American College of Cardiology·Ricardo FonsecaThomas H Marwick
Jan 12, 2020·The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology·Adham AbdeltawabMona Rayan

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