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
J Am Coll Cardiol. 2008 Mar 18;51(11):1127-47. doi: 10.1016/j.jacc.2007.12.005.
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评估。该评估针对多种适应症或临床情况，考量了负荷超声心动图的风险与获益，并根据ACCF制定的评估成像适用性的方法，在1至9分的范围内对其进行评分。高分范围（7至9）表明该检查总体上可接受且是合理的方法，低分范围（1至3）表明该检查总体上不可接受且不是合理的方法。中间范围（4至6）表示负荷超声心动图检查指征不确定的临床情况。此次评估的适应症源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心病（CAD）患者的风险评估受到认可，而在某些临床情况下的常规重复检查和一般筛查则不太被看好。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。
