At this year’s 2009 American College of Cardiology (ACC) sessions, speakers presented retrospective data on cardiovascular stress imaging ordering and reviewed new 2009 ACCF/AHA “Appropriateness Use Criteria” (AUC).

Specifically, physicians discussed new diagnostic definitions pertaining to chest pain and coronary heart disease, and new assumptions pertaining to facility accreditation and stress protocols.

For example, the stress component for cardiac imaging was defined as exercise reaching 80-85% of the maximum predicted heart rate. The goal of the new criteria is to better define value and to develop simplified ordering indication algorithms for physicians.

Speakers underscored the value of using AUCs to preserve access to procedures and maintain consistent reimbursement. They also recommended implementing AUCs at the point of order via EMRs.

The new AUCs were defined by the following scale:
7-9 = Appropriate test ordered
4-6 = Uncertain test ordered
1-3 = Inappropriate test ordered

Key takeaways

* High risk patients may not be getting the testing they need.
* More consistent guideline communication between the ACCF/AHA and Nuclear Boards is needed.
* More pilot studies are being done to explore methods to improve tracking of AUCs.
* More information and better education for ordering Primary Care physicians is needed.

• 48% of patients refereed for stress imaging were low risk, asymptomatic patients.
• Speakers suggested using tools like Web-based Palms or pocket guides with the new AUC indications

For more information, please visit www.ACC.org and reference iScience 2009, Meeting on Demand.

Photo credit: ACC Web site

Related Products

• Quinton Q-Stress cardiac stress machine
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• Quinton HeartStride cardiac stress test
• Quinton TM55/TM65 stress treadmill

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