Hendel Robert C
Cardiology, Midwest Heart Specialists, Fox River Grove, Illinois, USA.
JACC Cardiovasc Imaging. 2008 Mar;1(2):241-8. doi: 10.1016/j.jcmg.2008.01.008.
Rapid technological advances with enhanced clinical application have promoted the utility as well the growth of cardiac imaging. However, this has also raised concerns about over-utilization and inappropriate use in imaging. The imaging community, which initially took pride in increasing imaging volume, now fears limited access and reduced reimbursement. Nonclinicians, i.e., payers, have become gatekeepers to cardiac imaging, with decisions often lacking firm foundation within medical literature. The near-ubiquitous presence of radiology benefits managers is clearly impacting on the use of cardiac imaging, often through an indiscriminant reduction in imaging volume. Medical societies and clinicians were slow to respond to spiraling costs of cardiac imaging, but now recognize the need to promote appropriate and cost-conscious use of imaging. Through the development of guidelines and appropriateness criteria, physician-directed efforts are focused on eliminating unnecessary testing and promoting increased awareness of health care costs. This paper attempts to review some of the current issues concerning the responsible use of cardiovascular imaging.
随着临床应用的不断增强，快速的技术进步推动了心脏成像技术的应用及其发展。然而，这也引发了人们对成像过度使用和不当使用的担忧。最初以增加成像量为荣的成像界，如今担心获取受限和报销减少。非临床医生，即付款方，已成为心脏成像的把关者，其决策往往在医学文献中缺乏坚实依据。放射学福利管理人员几乎无处不在，这显然正在影响心脏成像的使用，通常是通过不加区分地减少成像量来实现的。医学协会和临床医生对心脏成像成本的螺旋式上升反应迟缓，但现在认识到有必要促进成像的合理使用并提高成本意识。通过制定指南和适宜性标准，医生主导的努力集中在消除不必要的检查，并提高对医疗保健成本的认识。本文试图回顾一些有关心血管成像合理使用的当前问题。
