Abstract:
OBJECTIVES:The purpose of this study was to apply published appropriateness criteria for single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI) in a single academic medical center. BACKGROUND:The American College of Cardiology Foundation (ACCF) and the American Society of Nuclear Cardiology (ASNC) have developed appropriateness criteria for stress SPECT MPI to address concern about the growth in cardiac imaging studies. METHODS:We retrospectively examined 284 patients who underwent stress SPECT MPI and 298 patients who underwent stress echocardiography before publication of these criteria. RESULTS:The overall level of agreement in characterizing appropriateness between 2 experienced cardiovascular nurse abstractors was modest (kappa = 0.56), but noticeably poorer (kappa = 0.27) for patients with previous SPECT or echo studies. Similar percentages of each imaging modality were assigned to the 3 appropriateness categories: 64% of stress SPECT and 64% of stress echo studies were classified appropriate; 11% of stress SPECT and 9% of stress echo were of uncertain appropriateness; and 14% of stress SPECT and 18% of stress echo were inappropriate. Of the inappropriate studies, 88% were performed for 1 of 4 indications. Approximately 10% of the patients were unclassifiable. CONCLUSIONS:Application of existing SPECT MPI appropriateness criteria is demanding and requires an established database or detailed data collection, as well as a number of assumptions. Fourteen percent of stress SPECT studies and 18% of stress echo studies were performed for inappropriate reasons. Quality improvement efforts directed at reducing the number of these inappropriate studies may improve efficiency in the health care system.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Gibbons RJ,Miller TD,Hodge D,Urban L,Araoz PA,Pellikka P,McCully RBdoi
10.1016/j.jacc.2007.10.064subject
Has Abstractpub_date
2008-04-01 00:00:00pages
1283-9issue
13eissn
0735-1097issn
1558-3597pii
S0735-1097(08)00256-8journal_volume
51pub_type
杂志文章abstract::Clot dissolution with restoration of infarct-related artery blood flow is the likely mechanism for the improved prognosis and mortality reduction seen after thrombolytic therapy of acute myocardial infarction. A pilot study has suggested that 100 mg of recombinant tissue-type plasminogen activator (rt-PA) infused over...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/0735-1097(92)90131-6
更新日期:1992-07-01 00:00:00
abstract::As a clinical entity atrioventricular (AV) block due to hypothyroidism is rare. Such a case induced by hypothyroidism complicating long-term therapy with amiodarone in a 45 year old woman with pre-excitation is presented. Electrophysiologic data obtained before and during thyroxine replacement therapy showed that hypo...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80279-0
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doi:10.1016/j.jacc.2006.08.063
更新日期:2007-02-20 00:00:00
abstract::Doppler echocardiography was performed in 80 consecutive patients (22 men, 58 women), aged 38 +/- 16 years, who had mitral valve prolapse diagnosed by two-dimensional echocardiography. Of the 80 patients, 16 (20%) were asymptomatic and 11 (14%) had a normal physical examination (no click or murmur). The M-mode echocar...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80214-5
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doi:10.1016/s0735-1097(97)00437-3
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,评论,杂志文章,随机对照试验
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更新日期:2003-01-15 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(97)00111-3
更新日期:1997-07-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(93)90487-l
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(89)90605-0
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
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更新日期:2012-07-03 00:00:00
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journal_title:Journal of the American College of Cardiology
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doi:10.1016/0735-1097(94)90016-7
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(86)80232-7
更新日期:1986-05-01 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00108-4
更新日期:1999-06-01 00:00:00
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journal_title:Journal of the American College of Cardiology
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pub_type: 杂志文章
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journal_title:Journal of the American College of Cardiology
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(90)90579-e
更新日期:1990-08-01 00:00:00
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更新日期:2000-11-01 00:00:00
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doi:10.1016/j.jacc.2004.02.064
更新日期:2004-10-06 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 传,历史文章,杂志文章
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更新日期:1985-05-01 00:00:00
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pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2008.12.044
更新日期:2009-04-14 00:00:00
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更新日期:2013-04-02 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 历史文章,杂志文章,评审
doi:10.1016/0735-1097(89)90293-3
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:The combination of autologous mesenchymal stem cells (MSCs) and cardiac stem cells (CSCs) synergistically reduces scar size and improves cardiac function in ischemic cardiomyopathy. Whereas allogeneic (allo-)MSCs are immunoevasive, the capacity of CSCs to similarly elude the immune system remains controversi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2017.09.036
更新日期:2017-11-14 00:00:00
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journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(95)00363-0
更新日期:1995-11-15 00:00:00
abstract:OBJECTIVES:An initial crossover study comparing dual- and single-site right atrial pacing was performed followed by a long-term efficacy and safety evaluation of dual-site right atrial pacing in patients with drug-refractory atrial fibrillation (AF). Also examined was the efficacy of two single-site right atrial pacing...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章
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更新日期:1998-12-01 00:00:00