Study: Clinical decision tool improves appropriate heart imaging

A tool based on American College of Cardiology (ACC) criteria has been shown to increase the number of appropriate cardiac imaging exams and reduce inappropriate ones, according to a study by researchers at Weill Cornell Medical College and several other U.S. institutions.

The decision-support tool was used instead of radiology benefits managers (RBMs), which traditionally serve as gatekeepers. RBMs generally approve or reject requests for tests based on appropriateness guidelines and partly on proprietary insurer-specific criteria that are not disclosed, which has been a source of criticism, reports Aunt Minnie. UnitedHealthcare, one of the study's sponsors, instead allowed doctors to solely rely on the tool to make those decisions

The trial involved 100 doctors and nearly 500 patients scanned over eight months. In the first two months, less than half the tests were deemed appropriate, but that rate grew to more than 60 percent in the final two months when using the software. Meanwhile, the proportion of inappropriate studies dropped from 22 percent to 6 percent.

Changes in medical therapy also increased from 11 percent to 32 percent, probably associated with fewer inappropriate tests that required no changes, according to Aunt Minnie.

In an effort to make its own appropriateness criteria the de facto national standard, the American College of Radiology (ACR) has been commercializing its own clinical decision-support system, which is being integrated into computerized physician order-entry systems.

It covers cover more than 1,380 topics and 614 variant conditions, and provides data-driven guidance for ordering tests, a second Aunt Minnie article says.

Meanwhile, Positron emission tomography (PET) technology combined with computed tomography (CT) technology could help doctors more accurately predict a patient's risk of having a heart attack, according to a study published recently in the Journal of the American College of Cardiology.

The American Medical Association House of Delegates recently adopted a resolution backing ultrasound's safety and effectiveness and supporting education efforts to promote it, reports Science Codex.

While medical imaging has many demonstrated benefits, the industry for years has been trying to set appropriate standards and protocols to reduce radiation exposure various patient groups, especially children.

To learn more:

– read the Aunt Minnie article
– check out the ACR story
– check out the Science Codex piece.

ACR standard for medical imaging protocols now accessible on EHR platform
Combined medical scans used to predict heart attack risk
Study: CT scans in children increase risk of leukemia, brain cancer
FDA, researchers push for 'child-size' imaging
Researchers work toward safer imaging for obese patients
Unnecessary imaging for cancer patients persists


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