Appropriate Use Criteria Improved Some Cardiac Imaging

March 10, 2015

Use of some cardiac imaging improved after implementation of appropriate use criteria, but not for all tests.

Rates of reported appropriate use in cardiac imaging show improvements only for some forms of testing, according to a study published in the Journal of the American College of Cardiology.

Researchers from Australia performed a study to determine if appropriate use criteria (AUC) for cardiac imaging have led to an improvement in the volume of cardiac imaging requests. The AUC has been available for almost 10 years now.

The researchers searched electronic databases for appropriate papers, and found 59 reports published from 2000 to 2012, involving a total of 103,567 examinations.

The results showed that there were improvements associated with the AUC for some imaging tests, but not all:

 Before AUCAfter AUC
Transthoracic echocardiography (TTE)80%85%
Transesophageal echocardiography89%95%
Computed tomography angiography (CTA)37%55%
Stress echocardiography53%52%
Single-photon emission computed tomography72%68%







“Although there were no correlations between the proportion of appropriate TTEs and published year for 2007 AUC, there was a positive correlation between proportion of appropriateness and the year of publication for 2011 AUC,” the authors wrote. “There was a significant decrease in the proportion of appropriateness over time using the 2007 TEE AUC and 2006 CT AUC.” This was not found for stress echocardiography, CTA, or single-photon emission computed tomography.

The researchers concluded that AUC did result in some improvements for cardiac imaging, however not for all types of tests.