Application of appropriatenes criteria to stress single photon emission computed tomography sestamibi studies: A comparison of the 2009 revised appropriateness criteria to the 2005 original criteria

Background The 2005 appropriate use criteria (AUC) for stress single-photon emission computed tomographic myocardial perfusion imaging (SPECT MPI) were revised in 2009 to reflect changes in published evidence, clinical practice and experience with application of the 2005 AUC. The purpose of this stu...

Full description

Saved in:
Bibliographic Details
Published in:The American heart journal 2010-08, Vol.160 (2), p.244-249
Main Authors: Carryer, Damita J., RN, Hodge, David O., MSc, Miller, Todd D., MD, Askew, John W., MD, Gibbons, Raymond J., MD
Format: Article
Language:English
Subjects:
Cardiology
Cardiovascular
Cardiovascular disease
Classification
Coronary vessels
Health care policy
Heart attacks
Medical imaging
Pain
Patients
Studies
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background The 2005 appropriate use criteria (AUC) for stress single-photon emission computed tomographic myocardial perfusion imaging (SPECT MPI) were revised in 2009 to reflect changes in published evidence, clinical practice and experience with application of the 2005 AUC. The purpose of this study was to compare the 2009 AUC for SPECT MPI with the original 2005 criteria. Methods Using the Mayo Rochester Nuclear Cardiology Laboratory database, we retrospectively examined 281 patients who underwent stress SPECT MPI at Mayo Clinic Rochester between May 1, 2005, and May 15, 2005, using the revised 2009 AUC and compared these findings to our previously published results in this same cohort using the 2005 AUC. Results Compared to the 2005 AUC, the 2009 AUC resulted in a highly significant overall change ( P < .001) in the classification of appropriateness. The 2009 AUC eliminated unclassified patients, reduced appropriate studies (59.8% vs 63.7%, P = .02), increased studies of uncertain appropriateness (16.0% vs 10.7%, P = .01), and increased inappropriate studies (24.2% vs 14.6%, P < .001). Conclusions In this cohort of patients undergoing SPECT MPI, compared to our previous study using the original 2005 AUC, the 2009 AUC had a significant impact on the classification of appropriateness. The 2009 AUC eliminated unclassified patients, increased inappropriate studies and increased studies of uncertain appropriateness.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2010.06.008