Society for Cardiovascular Angiography and Interventions Representative.
Catheter Cardiovasc Interv. 2012 Sep 1;80(3):E50-81. doi: 10.1002/ccd.24467. Epub 2012 Jun 7.
The American College of Cardiology Foundation, in collaboration with the Society for Cardiovascular Angiography and Interventions and key specialty and subspecialty societies, conducted a review of common clinical scenarios where diagnostic catheterization is frequently considered. The indications (clinical scenarios) were derived from common applications or anticipated uses, as well as from current clinical practice guidelines and results of studies examining the implementation of noninvasive imaging appropriate use criteria. The 166 indications in this document were developed by a diverse writing group and scored by a separate independent technical panel on a scale of 1 to 9, to designate appropriate use (median 7 to 9), uncertain use (median 4 to 6), and inappropriate use (median 1 to 3). Diagnostic catheterization may include several different procedure components. The indications developed focused primarily on 2 aspects of diagnostic catheterization. Many indications focused on the performance of coronary angiography for the detection of coronary artery disease with other procedure components (e.g., hemodynamic measurements, ventriculography) at the discretion of the operator. The majority of the remaining indications focused on hemodynamic measurements to evaluate valvular heart disease, pulmonary hypertension, cardiomyopathy, and other conditions, with the use of coronary angiography at the discretion of the operator. Seventy-five indications were rated as appropriate, 49 were rated as uncertain, and 42 were rated as inappropriate. The appropriate use criteria for diagnostic catheterization have the potential to impact physician decision making, healthcare delivery, and reimbursement policy. Furthermore, recognition of uncertain clinical scenarios facilitates identification of areas that would benefit from future research. © 2012 Wiley Periodicals, Inc.
美国心脏病学会基金会与心血管血管造影和介入学会以及主要专业和亚专业学会合作,对经常考虑进行诊断性导管插入术的常见临床情况进行了审查。这些适应症(临床情况)源自常见的应用或预期用途,以及当前的临床实践指南和检查非侵入性成像适当使用标准实施情况的研究结果。本文档中的 166 项适应症由一个多元化的写作小组制定,并由一个独立的技术小组进行评分,评分为 1 到 9 分,以指定适当的用途(中位数为 7 到 9 分)、不确定的用途(中位数为 4 到 6 分)和不适当的用途(中位数为 1 到 3 分)。诊断性导管插入术可能包括几种不同的程序组件。制定的适应症主要集中在诊断性导管插入术的两个方面。许多适应症主要集中在进行冠状动脉造影以检测冠状动脉疾病上,其他程序组件(例如,血流动力学测量,心室造影)由操作者酌情进行。其余大多数适应症主要集中在血流动力学测量上,以评估瓣膜性心脏病、肺动脉高压、心肌病和其他疾病,操作者可酌情使用冠状动脉造影。75 项适应症被评为适当,49 项被评为不确定,42 项被评为不适当。诊断性导管插入术的适当使用标准有可能影响医生的决策、医疗服务的提供和报销政策。此外,对不确定的临床情况的认识有助于确定哪些领域将受益于未来的研究。©2012 威利父子公司