Abstract 19920: Is Appropriate Criteria Appropriate to Assess Clinical Outcomes? Evaluation of SPECT Imaging Appropriateness Criteria using Clinical Outcomes
Is Appropriate Criteria Appropriate to Assess Clinical Outcomes? Evaluation of SPECT Imaging Appropriateness Criteria using Clinical Outcomes: SPECT Appropriateness Criteria (AC) has been used to guide imaging utilization over the last 5 years. However, the impact of AC on clinical outcomes has not been well studied. We sought to evaluate the use of AC to assess pts' cardiac events.
Methods: Consecutive pts in the Dept of Cardiology and Medicine over 6 months were included. New SPECT AC (2009) was used as the standard to assess appropriateness for SPECT use. SPECT imaging, outpatient visits and the cardiac events (Hospitalization, PCI, CABG, MI and Death) were analyzed.
Results: Out of 32,961 consecutive pts, 327 (1%) pts had events. Seventy-nine pts (24%) were Uncertain or non-categorized based on the AC. Of the 248 remaining pts, 41% pt (n= 102) with events were Inappropriate but had SPECT scans. Out of the 102 pts, 58% (n= 59) were asymptomatic with low risk CAD (ATP III score 3%) and 11% (n= 11) asymptomatic with prior abnormal cath or SPECT.
Conclusion: This is the 1st study to use outcomes to judge appropriateness of AC as standard and SPECT utilization. The study suggests current indications need to have further expansion, especially to risk stratify asymptomatic pts with low clinical risk scores. Further studies are warranted for the accuracy and applicability of AC in clinic settings.
- © 2010 by American Heart Association, Inc.