Myocardial Perfusion Imaging Judging Method Evaluated

Automated system found feasible for classifying appropriateness of MPI in patients

THURSDAY, Dec. 10 (HealthDay News) -- Evaluating the appropriateness of myocardial perfusion imaging (MPI) is possible in a clinical setting using an automated system, which may help reduce imaging overuse, according to research published online Dec. 10 in the Journal of the American College of Cardiology.

Robert C. Hendel, M.D., of Midwest Heart Specialists in Winfield, Ill., and colleagues analyzed data from 6,351 patients who underwent single-photon emission computed tomography MPI at six clinical sites. An algorithm, using previously published appropriate use criteria (AUC), was used to classify scans as appropriate, inappropriate, uncertain or unclassifiable.

The researchers note that the level of appropriateness was determined in 93 percent of patients. Of evaluable subjects, MPI was used appropriately in 70.7 percent of cases and inappropriately in 14.4 percent, with an uncertain level of appropriateness in 14.9 percent. Inappropriate testing was done more often in patients younger than 65 years and in women.

"Noninvasive imaging plays a major role in the evaluation and management of patients with coronary heart disease. The most efficient use of noninvasive testing involves matching the right test to the right patient. The rapid rate of growth of cardiac imaging suggests overuse, creating waste in the medical system," write the authors of an accompanying editorial. "Hendel et al have demonstrated a practical and efficient method to facilitate application of AUC in clinical practice. Strengthening the AUC ratings process would enhance the credibility of using AUC to control medical costs."

The study was supported by UnitedHealthcare. Several co-authors reported financial relationships with this company or other companies, as well as with the American College of Cardiology. The editorial authors also reported relationships with several companies.

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