2015 ACR/ACC/AHA/AATS/ACEP/ASNC/NASCI/SAEM/SCCT/SCMR/SCPC/SNMMI/STR/STS Appropriate Utilization of Cardiovascular Imaging in Emergency Department Patients With Chest Pain: A Joint Document of the American College of Radiology Appropriateness Criteria Committee and the American College of Cardiology Appropriate Use Criteria Task Force

• Published in: Journal of the American College of Cardiology 2016-02, Vol.67 (7), p.853-879
• Main Authors: Rybicki, Frank J, Udelson, James E, Peacock, W Frank, Goldhaber, Samuel Z, Isselbacher, Eric M, Kazerooni, Ella, Kontos, Michael C, Litt, Harold, Woodard, Pamela K
• Format: Article
• Language: English
• Subjects: Advisory Committees - organization & administration; Angina Pectoris - diagnostic imaging; Bisexuality; Cardiac Imaging Techniques - utilization; Cardiology; Cardiology - standards; Chest Pain - diagnostic imaging; Electrocardiography; Emergency Service, Hospital - standards; Gays & lesbians; Guidelines as Topic; Heart attacks; Humans; Radiography; Radiology; Risk factors; Societies, Medical; United States
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2015.09.011

Emergency Department Patients With Chest Pain Rating Panel Joseph S. Alpert, MDd George A. Andrews, MD, MBA, CPEe Edward P. Chen, MDf David T. Cooke, MDg Ricardo C. Cury, MDh Daniel Edmundowicz, MDi Victor Ferrari, MDj Louis G. Graff, MDk Judd E. Hollander, MDl Lloyd W. Klein, MDa Jonathan Leipsic, MDm Phillip D. Levy, MD, MPHn John J. Mahmarian, MDo Craig Rosenberg, MDp Geoffrey Rubin, MDa R. Parker Ward, MDq Charles White, MDr Appropriate Utilization of Cardiovascular Imaging Oversight Committee ACR E. Kent Yucel, MD, FACR, Co-Chaira J. Jeffrey Carr, MD, MSc, FACRa Frank J. Rybicki, MD, PhD, FACRa Richard D. White, MD, FACRa Pamela K. Woodard, MD, FACRa ACC Manesh Patel, MD, FACC, Co-Chairb Pamela Douglas, MD, MACCb Robert C. Hendel, MD, FACCb Christopher Kramer, MD, FACCb John Doherty, MD, FACCb Table of Contents Introduction856 Rating Guide856 Methods for Establishing Appropriate Use of Imaging in ED Patients With CP856 Clinical Scenario and Indication Identification by Writing Group856 Definition of Appropriateness856 Definitions858 Non-ST-Segment Elevation ACS858 AAS858 CP Related to ACS858 Abbreviations (See Appendix 1)858 Assumptions858 General Clinical Assumptions858 Practice Parameters/Standard of Care858 Cost/Value858 Guidance Specifically for Appropriate Use Criteria Users858 Entry Criteria Into Algorithms858 Testing Considerations859 Comorbidities and Contraindications860 Availability and Expertise860 Assessing the Risk for ACS in Patients With Suspected ACS861 Section 1: Overall Likelihood of ACS, PE, or AAS Is Not Low872 President and Staff872 ACR Board of Chancellors Chair and Staff872 American College of Cardiology President and Staff872 References872 Appendix 1 Abbreviations877 Appendix 2 ACR/ACC/AHA/AATS/ACEP/ASNC/NASCI/SAEM/SCCT/SCMR/SCPC/SNMMI/STR/STS 2015 Appropriate Utilization Of Cardiovascular Imaging in Emergency Department Patients With CP Writing Group, Rating Panel, Task Force, and Indication Reviewers--Relationships With Industry and Other Entities (Relevant)878 Introduction The 2010 National Hospital Medical Care Survey reported nearly 130 million emergency department (ED) visits (1).