CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography

Foldyna, Borek; Szilveszter, Bálint; Scholtz, Jan-Erik; Banerji, Dahlia; Maurovich-Horvat, Pál; Hoffmann, Udo

doi:10.1007/s00330-017-5105-4

Cited by 37 publications

(29 citation statements)

References 40 publications

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“…Secondly, in the student group which used ESR eGUIDE first, similarly high appropriate test ordering was found when this group analyzed the second set of clinical scenarios without ESR eGUIDE. This suggests that sustained skills might develop with the use of ESR eGUIDE and persist even in future settings when clinical decision support systems [17,18] are not at hand anymore.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

et al. 2020

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Objectives To evaluate ESR eGUIDE—the European Society of Radiology (ESR) e-Learning tool for appropriate use of diagnostic imaging modalities—for learning purposes in different clinical scenarios. Methods This anonymized evaluation was performed after approval of ESR Education on Demand leadership. Forty clinical scenarios were developed in which at least one imaging modality was clinically most appropriate, and the scenarios were divided into sets 1 and 2. These sets were provided to medical students randomly assigned to group A or B to select the most appropriate imaging test for each scenario. Statistical comparisons were made within and across groups. Results Overall, 40 medical students participated, and 31 medical students (78%) answered both sets. The number of correctly chosen imaging methods per set in these 31 paired samples was significantly higher when answered with versus without use of ESR eGUIDE (13.7 ± 2.6 questions vs. 12.1 ± 3.2, p = 0.012). Among the students in group A, who first answered set 1 without ESR eGUIDE (11.1 ± 3.2), there was significant improvement when set 2 was answered with ESR eGUIDE (14.3 ± 2.5, p = 0.013). The number of correct answers in group B did not drop when set 2 was answered without ESR eGUIDE (12.4 ± 2.6) after having answered set 1 first with ESR eGUIDE (13.0 ± 2.7, p = 0.66). Conclusion The clinical decision support tool ESR eGUIDE is suitable for training medical students in choosing the best radiological imaging modality in typical scenarios, and its use in teaching radiology can thus be recommended. Key Points • ESR eGUIDE improved the number of appropriately selected imaging modalities among medical students. • This improvement was also seen in the group of students which first selected imaging tests without ESR eGUIDE. • In the student group which used ESR eGUIDE first, appropriate selection remained stable even without the teaching tool.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

et al. 2020

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“…The angiographic criteria were MI or stress testpositive patients or diabetic patients experiencing chest pain. If stenosis was greater than 70% based on angiography, 15 the patient was eligible for inclusion in this study as a case. Patients were interviewed on the second or third day after angiography if they were stable.…”

Section: Study Design and Participantsmentioning

confidence: 99%

Association of smoking with coronary artery disease in Nepalese populations: a case control study

Basnet

Mallah

et al. 2019

Toxicology Research

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There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case–control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21–2.7) and OR: 5.2 (CI: 3.4–7.97)), with p-values less than 0.004 and <0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64–12.12, p < 0.00001; OR: 1.89, 95% CI: 1.08–3.31, p < 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.

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“…The CAD-RADS classification is one of these reporting systems that have been emerged recently. A few numbers of recent studies have been published explaining the CAD-RADS in details and clarifying the pitfalls and limitations of this classification system [17][18][19]. However, since the pioneering report from Curye et al in 2016, no study has been performed for external validation of the CAD-RADS.…”

Section: Discussionmentioning

confidence: 99%

The validity and applicability of CAD-RADS in the management of patients with coronary artery disease

et al. 2019

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Background: The coronary artery disease reporting and data system (CAD-RADS) is designed for a uniform standardization of coronary computed tomography angiography (CCTA) reporting and further management recommendations of coronary artery disease (CAD). This study aimed to assess clinical validity, applicability, and reproducibility of CAD-RADS in the management of patients with CAD. Methods and results:A single-center prospective study included 287 patients with clinically suspected or operated CAD who underwent CCTA. Four reviewers evaluated the CCTA images independently and assigned a CAD-RADS category to each patient. The invasive coronary angiography (ICA) was used as the reference standard for calculating diagnostic performance of CAD-RADS for categorizing the degree of coronary artery stenosis. The intra-class correlation (ICC) was used to test the inter-reviewer agreement (IRA). Reporting was provided to referring consultants according to the CAD-RADS. Based on ICA results, we have 156 patients with non-significant CAD and 131 patients with significant CAD. On a patient-based analysis, regarding those patients classified as CAD-RADS 4 and CAD-RADS 5 for predicting significant CAD, the CAD-RADS had a sensitivity, specificity, and an accuracy of 100%, 96.8 to 98.7%, and 98.3 to 99.3%, respectively, depending on the reviewer. There was an excellent IRA for CAD-RADS categories (ICC = 0.9862). The best cutoff value for predicting significant CAD was > CAD-RADS 3. Eightyseven percentage of referring consultants considered CAD-RADS reporting system to be "quite helpful" or "completely helpful" for clinical decision-making in CAD.Conclusion: CAD-RADS is valuable for improving CCTA structural reports and facilitating decision-making with high diagnostic accuracy and high reproducibility.

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CAD-RADS – a new clinical decision support tool for coronary computed tomography angiography

Abstract: • CAD-RADS is a tool for standardising coronary CTA reports. • CAD-RADS includes clinical treatment recommendations based on CTA findings. • CAD-RADS has the potential to reduce variability of CTA reports.

Cited by 37 publications

References 40 publications

Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

Effectiveness of the clinical decision support tool ESR eGUIDE for teaching medical students the appropriate selection of imaging tests: randomized cross-over evaluation

Association of smoking with coronary artery disease in Nepalese populations: a case control study

The validity and applicability of CAD-RADS in the management of patients with coronary artery disease

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