Appropriateness criteria issued for cardiac computed tomography, cardiac magnetic resonance imaging

e and a reasonable approach for the indication. Negative consequences include the risks of the procedure (i.e., radiation or contrast exposure) and the downstream impact of poor test performance such as the delay in diagnosis (false negatives) or inappropriate diagnosis (false positives).

The 39 CCT and 33 CMR indications rated by a technical panel of experts encompassed the majority of clinical scenarios referred for CCT and CMR, respectively.

"This is the first information available to clinicians and payers to help guide decisions on when to use these two newer imaging procedures in certain clinical scenarios. With payment decisions being made daily and without any criteria to guide clinicians and payers, the ACCF and its partners felt it was critical to provide these criteria now," said Christopher Kramer, M.D., F.A.C.C., a member of the writing group for the Appropriateness Criteria.

These appropriateness reviews assessed the risks and benefits of the imaging tests for several indications or clinical scenarios and scored them based on a scale of 1-9, where the upper range (7-9) implies that the test is generally acceptable and is a reasonable approach, and the lower range (1-3) implies that the test is generally not acceptable and is not a reasonable approach. The mid range (4-6) indicates an uncertain clinical scenario. The indications for these reviews were drawn from common applications or anticipated uses, as few clinical practice guidelines currently exist for these techniques. These indications were reviewed by an independent group of clinicians and modified by the Working Group, and then panelists rated the indications based on the ACCF Methodology for Evaluating the Appropriateness of Cardiovascular Imaging, which blends a broad range of clinical experience and available evidence-based information.

"We recommend that cardiovascular professionals use the CCT and CMR Appropriateness Criteria to avoid order

Contact: Amy Murphy
American College of Cardiology

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