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Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter.

ABSTRACT: BACKGROUND:The healthcare burden posed by the coronavirus disease 2019 (COVID-19) pandemic in the New York Metropolitan area has necessitated the postponement of elective procedures resulting in a marked reduction in cardiac catheterization laboratory (CCL) volumes with a potential to impact interventional cardiology (IC) fellowship training. METHODS:We conducted a web-based survey sent electronically to 21 Accreditation Council for Graduate Medical Education accredited IC fellowship program directors (PDs) and their respective fellows. RESULTS:Fourteen programs (67%) responded to the survey and all acknowledged a significant decrease in CCL procedural volumes. More than half of the PDs reported part of their CCL being converted to inpatient units and IC fellows being redeployed to COVID-19 related duties. More than two-thirds of PDs believed that the COVID-19 pandemic would have a moderate (57%) or severe (14%) adverse impact on IC fellowship training, and 21% of the PDs expected their current fellows' average percutaneous coronary intervention (PCI) volume to be below 250. Of 25 IC fellow respondents, 95% expressed concern that the pandemic would have a moderate (72%) or severe (24%) adverse impact on their fellowship training, and nearly one-fourth of fellows reported performing fewer than 250 PCIs as of March 1st. Finally, roughly one-third of PDs and IC fellows felt that there should be consideration of an extension of fellowship training or a period of early career mentorship after fellowship. CONCLUSIONS:The COVID-19 pandemic has caused a significant reduction in CCL procedural volumes that is impacting IC fellowship training in the NY metropolitan area. These results should inform professional societies and accreditation bodies to offer tailored opportunities for remediation of affected trainees.

SUBMITTER: Gupta T

PROVIDER: S-EPMC7276744 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter.

Gupta Tanush T Nazif Tamim M TM Vahl Torsten P TP Ahmad Hasan H Bortnick Anna E AE Feit Frederick F Jauhar Rajiv R Kandov Ruben R Kim Michael M Kini Annapoorna A Lawson William W Leber Robert R Lee Alexander A Moreyra Abel E AE Minutello Robert M RM Sacchi Terrence T Vaidya Pranaychan J PJ Leon Martin B MB Parikh Sahil A SA Kirtane Ajay J AJ Kodali Susheel S

Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 20200516 2

<h4>Background</h4>The healthcare burden posed by the coronavirus disease 2019 (COVID-19) pandemic in the New York Metropolitan area has necessitated the postponement of elective procedures resulting in a marked reduction in cardiac catheterization laboratory (CCL) volumes with a potential to impact interventional cardiology (IC) fellowship training.<h4>Methods</h4>We conducted a web-based survey sent electronically to 21 Accreditation Council for Graduate Medical Education accredited IC fellows ...[more]

PMID: 32415916

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Project description:IntroductionCardiac catheterization procedures result in high radiation doses and often multiple procedures are necessary for congenital heart disease patients. However, diagnostic reference levels (DRL) remain scarce. Our first goal was finding the optimal DRL parameter and determining appropriate DRLs. The second goal was to calculate organ doses (OD), effective doses (ED) and lifetime attributable risks (LAR) per procedure and to provide conversion factors based on dose area product (DAP).Materials and methodsDRLs are calculated for each procedure type, as the 75th percentile of the cumulative value per procedure from the corresponding parameter. All irradiation events in the DICOM Structured Reports were automatically processed and simulated using PCXMC, resulting in OD, ED and LAR. Using a Kruskal Wallis H test and subsequent pairwise comparisons, differences in median values of the DRL parameter between procedure types were assessed.ResultsLinear regression showed a strong correlation and narrow confidence interval between DAP and product of body weight and fluoroscopy time (BWxFT), even when all procedures (diagnostic and interventional) are combined. Only 15% of the pairwise comparisons were statistically significant for DAP normalized to BWxFT (DAPBWxFT). The latter pairs contained less frequent procedure types with significant outliers. For DAP normalized to BW (DAPBW), 38% of the pairwise comparisons showed statistically significant differences. Conversion factors from DAPBW to OD and ED were reported for various weight groups, due to the higher correlation between DAPBW and both OD and ED than between DAP and both OD and ED.ConclusionsThe P75 of DAPBWxFT for all procedures combined serves as an appropriate DRL value. This facilitates local DRL determination in smaller paediatric centres, which often have insufficient data to produce appropriate DRLs for different procedure types. Conversion factors are more reliable starting from DAPBW instead of DAP and should be used according to the appropriate BW group.

Dataset Information

Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter.

Publications

Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter.

Similar Datasets

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