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美国放射学会适宜性标准® 急性非特异性胸痛 - 冠状动脉疾病低概率

ACR Appropriateness Criteria® Acute Nonspecific Chest Pain-Low Probability of Coronary Artery Disease.

作者信息

Beache Garth M, Mohammed Tan-Lucien H, Hurwitz Koweek Lynne M, Ghoshhajra Brian B, Brown Richard K J, Davis Andrew M, Heitner John, Hsu Joe Y, Johri Amer M, Khosa Faisal, Kligerman Seth J, Litmanovich Diana, Maroules Christopher D, Meyersohn Nandini, Tomaszewski Christian A, Villines Todd C, Wann Samuel, Abbara Suhny

机构信息

University of Louisville School of Medicine, Louisville, Kentucky.

Research Author, University of Florida College of Medicine, Gainesville, Florida.

出版信息

J Am Coll Radiol. 2020 Nov;17(11S):S346-S354. doi: 10.1016/j.jacr.2020.09.006.

Abstract

Patients with acute nonspecific chest pain and low probability for coronary disease remain an important clinical management dilemma. We focus on evidence for imaging, in an integrated decision-making setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

摘要

患有急性非特异性胸痛且冠心病可能性较低的患者仍然是临床管理中的一个重要难题。我们在综合决策背景下关注影像学证据。美国放射学会适宜性标准是针对特定临床情况的循证指南,每年由多学科专家小组进行审查。指南的制定和修订包括对同行评审期刊上当前医学文献的广泛分析,以及应用成熟的方法(兰德/加州大学洛杉矶分校适宜性方法和推荐分级评估、制定与评价或GRADE)来评估特定临床场景下影像学和治疗程序的适宜性。在证据不足或不明确的情况下,专家意见可补充现有证据以推荐影像学检查或治疗。

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