American College of Cardiology, Cardiology Division, Washington Hospital Center, Washington, DC 20037, USA.
JACC Cardiovasc Imaging. 2013 Jul;6(7):823-9. doi: 10.1016/j.jcmg.2013.01.012. Epub 2013 May 1.
Resource-sensitive and quality-centered imaging begins with the selection of the appropriate patient and test. Appropriate use criteria have been developed to aid clinicians but are often not available in an easily accessible format. FOCUS (Formation of Optimal Cardiovascular Utilization Strategies), a Web-based community and quality improvement instrument, was developed to increase the feasibility of measuring and improving practice patterns based on the appropriate use criteria. The FOCUS instrument proposed to reduce inappropriate imaging by 15% in 1 year and by 50% within 3 years. Between April 2010 and December 2011, data were voluntarily collected through the FOCUS radionuclide imaging performance improvement module (PIM). Appropriateness rates were compared between phases of the PIM. For the 55 participating sites that had completed the PIM by December 2011, the proportion of inappropriate cases decreased from 10% to 5% (p < 0.0001). These preliminary data from initial participating sites suggest that through the use of a self-directed, quality improvement software and an interactive community, physicians may be able to significantly decrease the proportion of tests not meeting appropriate use criteria.
资源敏感且以质量为中心的影像学始于对合适患者和检查的选择。已经制定了适当使用标准来帮助临床医生，但通常无法以易于访问的格式提供。FOCUS（最佳心血管利用策略的形成）是一个基于网络的社区和质量改进工具，旨在提高基于适当使用标准衡量和改进实践模式的可行性。FOCUS 仪器提议在 1 年内将不合适的影像学检查减少 15%，在 3 年内减少 50%。在 2010 年 4 月至 2011 年 12 月期间，数据通过 FOCUS 放射性核素成像性能改进模块（PIM）自愿收集。在 PIM 的不同阶段比较了适宜率。对于在 2011 年 12 月前完成 PIM 的 55 个参与站点，不符合适当使用标准的病例比例从 10%降至 5%（p<0.0001）。来自最初参与站点的这些初步数据表明，通过使用自我指导、质量改进软件和交互式社区，医生可能能够显著降低不符合适当使用标准的检查比例。
