Compliance with appropriate use criteria for cardiac radionuclide imaging

Excerpt

In 2009, the American College of Cardiology in collaboration with other specialty and subspecialty societies including the American Society of Nuclear Cardiology updated the appropriateness use criteria (AUC) for cardiac radionuclide imaging.1 The original AUC criteria were published in 2005. These criteria are generated from technical panels using a modified Delphi exercise. They combine evidence-based medical information and expert opinion. For the 2009 update, the panels were asked to consider cost as an additional factor in their evaluation of appropriate use. The methodology used by the panels is well described.2 The revised AUC document1 lists 67 clinical scenarios scored by the panels on a scale of 1 to 9. Appropriate indications are those with median score of 7-9; uncertain indications are those with a median score of 4-6; inappropriate indications have scores ranging from 1 to 3. Regarding the latter, 25 are listed with many related to testing of asymptomatic or low risk patients, routine testing early after revascularization, preoperative testing of low-risk patients for noncardiac surgery and detection of CAD in non-acute symptomatic patients who have a low pretest probability of CAD, an interpretable baseline electrocardiogram and are able to exercise. …