Dataset Information

Appropriateness of inpatient stress testing: Implications for development of clinical decision support mechanisms and future criteria.

ABSTRACT:

Background

An upcoming national mandate will require consultation of appropriate use criteria (AUC) through a clinical decision support mechanism (CDSM) for advanced imaging. We aimed to evaluate our current ability to ascertain test appropriateness.

Methods

We prospectively collected data on 288 consecutive stress tests and coronary computed tomography angiography studies for medical inpatients. Study appropriateness was determined independently by two physicians using the 2013 Multimodality AUC.

Results

The median age of the study population was 66 years [interquartile range (IQR) 56, 75], 40.8% were female, and 52.8% had a history of coronary artery disease. Review of the electronic health record (EHR) alone was sufficient to deem appropriateness for 87.2% of cases. The most common reason it was insufficient was inability to determine if the patient could exercise (59.5%). After reviewing the EHR and pilot CDSM data together, appropriateness could be determined for 95.8% of the cases. The most common reason appropriateness could not be determined was that the exam indication was not addressed by an AUC criterion (83.3%).

Conclusion

In preparing for the mandate, it will be important for future CDSM to obtain information on the patient's ability to exercise and for future AUC to include additional indications that are not currently addressed.

SUBMITTER: Divakaran S

PROVIDER: S-EPMC7231672 | biostudies-literature | 2021 Oct

REPOSITORIES: biostudies-literature

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Publications

Appropriateness of inpatient stress testing: Implications for development of clinical decision support mechanisms and future criteria.

Divakaran Sanjay S Singh Avinainder A DeFilippis Ersilia M EM Churchill Timothy W TW Cuddy Sarah S Ge Yin Y Ip Ivan K IK Zhou Wunan W Skali Hicham H Taqueti Viviany R VR Dorbala Sharmila S Spalding James J Xu Yanqing Y Khorasani Ramin R Di Carli Marcelo F MF Yialamas Maria A MA Blankstein Ron R

Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology 20191118 5

<h4>Background</h4>An upcoming national mandate will require consultation of appropriate use criteria (AUC) through a clinical decision support mechanism (CDSM) for advanced imaging. We aimed to evaluate our current ability to ascertain test appropriateness.<h4>Methods</h4>We prospectively collected data on 288 consecutive stress tests and coronary computed tomography angiography studies for medical inpatients. Study appropriateness was determined independently by two physicians using the 2013 M ...[more]

PMID: 31741326

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Dataset Information

Appropriateness of inpatient stress testing: Implications for development of clinical decision support mechanisms and future criteria.

Background

Methods

Results

Conclusion

Publications

Appropriateness of inpatient stress testing: Implications for development of clinical decision support mechanisms and future criteria.

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