Abstract 212: Temporal Trends of Referral Patterns and Clinical Profile of Patients Referred for Coronary CT Angiography: Results From a Statewide Prospective Quality Improvement Initiative Registry (ACIC)
Objective: The Advanced Cardiovascular Imaging Consortium (ACIC) is a Michigan statewide prospective clinical quality improvement registry funded by Blue Cross Blue Shield of Michigan/Blue Care Network. Implementation of the ACIC-derived best practice models, training and educational activities may lead to a CTA referral pattern changes with increase in number of patients with appropriate indications for test. Accordingly, the present study examined temporal trends of the referral patterns for CCTA from July 2007 to April 2009 with assessment of the indications for the CTA referral, clinical status and demographics of the referred patients.
Methods: A total of 12,280 CTA patients were enrolled in the ACIC at 28 participating sites. Data regarding patient demographics, referral information, clinical and historical variables, CTA findings and short-term post-test outcomes were entered into the registry database prospectively. ACIC staff audited quality of the data at participating sites. After exclusion of 677 patients with incomplete referral or procedure data, the final study population included 11,603 patients (age 57+/−13 yrs; 54% males). Patterns of practice over sequential three month time periods were examined; temporal differences were evaluated using ANOVA and t-test methods for continuous variables, and Chi-square test-for categorical variables.
Results: Referral patterns of the patients enrolled in the ACIC are shown in Table⇓.
Conclusions: Participation in the ACIC is associated with a modest but significant trend of an increasing number of patients with prior inconclusive/nondiagnostic stress test results, and a decline in the number of patients with low likelihood of CAD and asymptomatic patients, as well as patients with typical angina, referred for CCTA.