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Application of appropriate use criteria for stress myocardial perfusion imaging at two academic medical centers: Compliance and association with image findings.
MedLine Citation:
PMID:  22486835     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract  Purpose: Explore the extent to which stress myocardial perfusion imaging (MPI) studies for coronary heart disease detection met published appropriate use criteria (AUC), and the association between AUC classification and image findings. Data sources: Retrospective, descriptive review of stress studies performed at the University of Washington Medical Center (UWMC n= 1377) and the Veterans Health Administration of Puget Sound (VA n= 1445) in the 31 months following AUC publication. Conclusions: At UWMC and VA, 69% and 89% of MPI studies, respectively, were classified as appropriate, 16% and 3% as inappropriate, and 15% and 8% as uncertain. All differences were significant, p < .001. At UWMC, 11% of appropriate studies and 10% of inappropriate or uncertain studies were abnormal (demonstrating myocardial ischemia or myocardial infarction), p= .93; these analyses were not performed on VA studies. Implications for practice: Most studies at both sites were classified as appropriate. At UWMC, the likelihood of a study classified as appropriate demonstrating an abnormality was not significantly different from a study classified as uncertain or inappropriate. AUC are imperfect tools but are increasingly created and referenced; as such, it is vital that practicing nurse practitioners are knowledgeable about their creation, application, and evaluation.
Authors:
Laurie A Soine; Susanna L Cunningham; Sandra A Motzer; Lurdes Y T Inoue; James H Caldwell
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-19
Journal Detail:
Title:  Journal of the American Academy of Nurse Practitioners     Volume:  24     ISSN:  1745-7599     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8916634     Medline TA:  J Am Acad Nurse Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  200-208     Citation Subset:  -    
Copyright Information:
©2011 The Author(s) Journal compilation ©2011 American Academy of Nurse Practitioners.
Affiliation:
Divisions of Nuclear Medicine and Cardiology, Department of Radiology and Medicine, University of Washington, Seattle, Washington School of Nursing, Department of Biobehavioral Nursing and Health Systems, University of Washington, Seattle, Washington School of Public Health, Department of Biostatistics, University of Washington, Seattle, Washington Divisions of Cardiology and Nuclear Medicine, Departments of Medicine and Radiology, University of Washington, Seattle, Washington.
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