J Am Coll Cardiol. 2012 Jul 17;60(3):242-76. doi: 10.1016/j.jacc.2012.02.009. Epub 2012 Jun 11.
The American College of Cardiology Foundation (ACCF), in partnership with key specialty and subspecialty societies, conducted a review of common clinical scenarios where noninvasive vascular testing (ultrasound and physiological testing) 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 the original appropriate use criteria (AUC). The 159 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). A total of 255 indications (with the inclusion of surveillance timeframes) were rated. One hundred and seventeen indications were rated as appropriate, 84 were rated as uncertain, and 54 were rated as inappropriate. The AUC for peripheral vascular disease 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.
美国心脏病学会基金会(ACCF)与主要的专业和亚专业学会合作,对经常考虑进行非侵入性血管检测(超声和生理检测)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原始适当使用标准(AUC)实施情况的研究结果。本文档中的 159 种适应症由不同的写作小组制定,并由另一个独立的技术小组根据 1 到 9 的评分进行评分,以指定适当的使用(中位数 7 到 9)、不确定的使用(中位数 4 到 6)和不适当的使用(中位数 1 到 3)。共对 255 种适应症(包括监测时间范围)进行了评分。117 种适应症被评为适当,84 种被评为不确定,54 种被评为不适当。外周血管疾病的 AUC 有可能影响医生的决策、医疗保健的提供和报销政策。此外,对不确定的临床情况的认识有助于确定需要进一步研究的领域。