Douglas Pamela S, Khandheria Bijoy, Stainback Raymond F, Weissman Neil J, Peterson Eric D, Hendel Robert C, Stainback Raymond F, Blaivas Michael, Des Prez Roger D, Gillam Linda D, Golash Terry, Hiratzka Loren F, Kussmaul William G, Labovitz Arthur J, Lindenfeld Joann, Masoudi Frederick A, Mayo Paul H, Porembka David, Spertus John A, Wann L Samuel, Wiegers Susan E, Brindis Ralph G, Douglas Pamela S, Hendel Robert C, Patel Manesh R, Peterson Eric D, Wolk Michael J, Allen Joseph M
Duke University Medical Center, Durham, NC, USA.
Catheter Cardiovasc Interv. 2008 Apr 1;71(5):E1-19. doi: 10.1002/ccd.21554.
The American College of Cardiology Foundation (ACCF) and the American Society of Echocardiography (ASE) together with key specialty and subspecialty societies, conducted an appropriateness review for stress echocardiography. The review assessed the risks and benefits of stress echocardiography for several indications or clinical scenarios and scored them on a scale of 1 to 9 (based upon methodology developed by the ACCF to assess imaging appropriateness). The upper range (7 to 9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1 to 3) implies that the test is generally not acceptable and is not a reasonable approach. The midrange (4 to 6) indicates a clinical scenario for which the indication for a stress echocardiogram is uncertain. The indications for this review were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Use of stress echocardiography for risk assessment in patients with coronary artery disease (CAD) was viewed favorably, while routine repeat testing and general screening in certain clinical scenarios were viewed less favorably. It is anticipated that these results will have a significant impact on physician decision making and performance, reimbursement policy, and will help guide future research.
美国心脏病学会基金会（ACCF）和美国超声心动图学会（ASE）联合主要专业和亚专业学会，对负荷超声心动图进行了适用性审查。该审查评估了负荷超声心动图在多种适应证或临床场景中的风险和益处，并根据1至9分的评分标准（基于ACCF制定的评估成像适用性的方法）对其进行评分。高分范围（7至9分）意味着该检查通常是可接受的，是一种合理的方法，而低分范围（1至3分）意味着该检查通常不可接受，不是一种合理的方法。中等范围（4至6分）表明负荷超声心动图检查适应证不确定的临床场景。本次审查的适应证来自常见应用或预期用途，以及当前的临床实践指南。负荷超声心动图用于冠状动脉疾病（CAD）患者的风险评估受到认可，而在某些临床场景中的常规重复检查和一般筛查则不太受认可。预计这些结果将对医生的决策和表现、报销政策产生重大影响，并有助于指导未来的研究。
