ACCF/ASE/ACEP/ASNC/SCAI/SCCT/SCMR 2007 Appropriateness Criteria for Transthoracic and Transesophageal Echocardiography⁎⁎Developed in accordance with the principles and methodology outlined by ACCF: Patel MR, Spertus JA, Brindis RG, Hendel RC, Douglas PS, Peterson E, Wolk MJ, Allen JM, Raskin IE. ACCF proposed method for evaluating the appropriateness of cardiovascular imaging. J Am Coll Cardiol 2005;46:1606-13 (1).

Douglas, Pamela S.; Khandheria, Bijoy K.; Stainback, Raymond F.; Weissman, Neil J.; Brindis, Ralph G.; Patel, Manesh R.; Alpert, Joseph S.; Fitzgerald, David M.; Heidenreich, Paul A.; Martin, Edward T.; Messer, Joseph V.; Miller, Alan B.; Picard, Michael H.; Raggi, Paolo; Reed, Kim D.; Rumsfeld, John S.; Steimle, Anthony; Tonkovic, Russ; Vijayaraghavan, Krishnaswami; Yeon, Susan B.; Hendel, Robert C.; Peterson, Eric D.; Wolk, Michael J.; Allen, Joseph M.

doi:10.1016/j.jacc.2007.05.003

Cited by 304 publications

(38 citation statements)

References 15 publications

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“…In both routine clinical 14,15 and research applications, 16 -18 evaluation of the hemodynamic performance of a bioprosthesis mainly depends on transprosthetic pressure gradients and orifice area. Pressure gradients are strongly flow dependent and thus vary greatly with left ventricular filling state and systolic function.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Knobelsdorff‐Brenkenhoff

Rudolph

Waßmuth

et al. 2009

Circ: Cardiovascular Imaging

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Background-Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses. Methods and Results-CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1Ϯ2.8 years; mean orifice area [TTE], 1.70Ϯ0.43 cm 2 ; 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, nϭ65) and TEE (planimetry, nϭ31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (rϭ0.82) and CMR with TEE (rϭ0.92) were significant. The average difference between the methods was Ϫ0.02Ϯ0.24 cm 2 (TTE) and 0.05Ϯ0.15 cm 2 (TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7Ϯ5.4% and 11.5Ϯ7.8%. Conclusions-The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency. (Circ Cardiovasc Imaging. 2009;2:397-404.)

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Section: Discussionmentioning

confidence: 99%

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Knobelsdorff‐Brenkenhoff

Rudolph

Waßmuth

et al. 2009

Circ: Cardiovascular Imaging

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“…The initial 2007 AUC categorized appropriateness by a relative score, with 7 to 9 defined as “appropriate,” 4 to 6 defined as “uncertain,” and 1 to 3 defined as “inappropriate” [6]. …”

Section: Development Of Aucmentioning

confidence: 99%

Appropriate Use Criteria for Echocardiography: Evolving Applications in the Era of Value-Based Healthcare

Singh

Ward

2016

Curr Cardiol Rep

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The current climate in healthcare is increasingly emphasizing a value-based approach to diagnostic testing. Cardiac imaging, including echocardiography, has been a primary target of ongoing reforms in healthcare delivery and reimbursement. The Appropriate Use Criteria (AUC) for echocardiography is a physician-derived tool intended to guide utilization in optimal patient care. To date, the AUC have primarily been employed solely as justification for reimbursement, though evolving broader applications to guide clinical decision-making suggest a far more valuable role in the delivery of high-quality and high-value healthcare.

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“…The first AUC (for SPECT) were launched at the end of 2005 and the first transthoracic (TTE) and transesophageal (TEE) echocardiography AUC document was released two years later [12,13]. Stress echocardiography (SE) was not included in the first version of the echocardiography AUC [14], but these criteria were merged in the 2011 version [15].…”

Section: Development and Application Of Appropriate Use Criteriamentioning

confidence: 99%

How I do it: judging appropriateness for TTE and TEE

Fonseca

Marwick

2014

Cardiovasc Ultrasound

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The increasing cost of healthcare is a widespread international problem to which the cost of imaging has been an important contributor. Some imaging tests are ordered inappropriately and contribute to wasted use of resources. Appropriate use criteria have been developed in the USA in order to guide test selection, but there are a number of problems, including the evidence base for these criteria and the steps that can be taken to change physician practice. A restrictive approach to test ordering is difficult to fit to the nuances of clinical presentation and may compromise patient care. We propose an alternative approach to physician guidance based on the most common markers of inappropriate testing.

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Cited by 304 publications

References 15 publications

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Appropriate Use Criteria for Echocardiography: Evolving Applications in the Era of Value-Based Healthcare

How I do it: judging appropriateness for TTE and TEE

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