Temporal trends in utilization of cardiac computed tomography.
Temporal trends in utilization of cardiac computed tomography.
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DOI：
10.1016/j.jcct.2008.10.009
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发表时间：
2009-01-01
影响因子：
5.4
通讯作者：
Sola, Srikanth
中科院分区：
文献类型：
--
作者：
Ayyad, Ala-Eddin M;Cole, Jason;Sola, Srikanth
背景技术背景：2006年的一份多协会文件定义了心脏计算机断层扫描（CT）的适当、不适当和不确定适应症。我们试图比较适当的心脏CT检查之前和之后，这些标准published.METHODS：我们回顾性评价了所有患者提出的心脏CT检查在2006年和2007年的前3个月在一个大型学术医疗中心和一个独立的大型心脏病组私人执业。根据患者的病历确定检查的适应症。然后根据适当性标准将检查分为“适当”、“不适当”或“不确定”。不属于任何这些类别的考试被归类为“未分类”。结果：我们共评估了1409例患者（64.9%为男性;平均年龄57.6 ± 13.4岁）。适当CT检查的比例从2006年研究期间的69.5%增加到2007年的78.5%（P = 0.001）。相应地，观察到不适当的CT检查从2006年的11.5%下降到2007年的4.6%（P = 0.001）。被认为不确定的CT检查数量没有变化（2006年为12.7%，2007年为13.3%; P = NS）。结论：在研究期间，被认为适当的CT检查数量增加，而不适当的检查数量减少。心脏病专家比非心脏病专家更有可能在研究期间安排适当的检查。
BACKGROUND: Appropriate, inappropriate, and uncertain indications for the use of cardiac computed tomography (CT) were defined by a multisociety document in 2006. We sought to compare the appropriateness of cardiac CT examinations before and after these criteria were published.METHODS: We retrospectively evaluated all patients presenting for cardiac CT examinations in the first 3 months of 2006 and 2007 at a large academic medical center and an unaffiliated large cardiology group private practice. The indication for the examinations were determined from the patients' medical records. The examinations were then classified as "appropriate," "inappropriate," or "uncertain," based on appropriateness criteria. Examinations that did not fall into any of these categories were classified as "uncategorized."RESULTS: We evaluated a total of 1409 patients (64.9% men; mean age, 57.6 +/- 13.4 years). The proportion of appropriate CT examinations increased from 69.5% during the study period in 2006 to 78.5% in 2007 (P = 0.001). A corresponding decrease was observed in inappropriate CT examinations from 11.5% in 2006 to 4.6% in 2007 (P = 0.001). No change was observed in the number of CT examinations that were deemed uncertain (12.7% in 2006, and 13.3% in 2007; P = NS).CONCLUSION: The number of CT examinations considered appropriate increased during the study period, whereas the number of inappropriate examinations decreased. Cardiologists were more likely than noncardiologists to order examinations that were appropriate during the study period.