ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease

Michael J. Wolk, Steven R Bailey, John U. Doherty, Pamela S. Douglas, Robert C. Hendel, Christopher M. Kramer, James K. Min, Manesh R. Patel, Lisa Rosenbaum, Leslee J. Shaw, Raymond F. Stainback, Joseph M. Allen, Ralph G. Brindis, Manuel D. Cerqueira, Jersey Chen, Larry S. Dean, Reza Fazel, W. Gregory Hundley, Dipti Itchhaporia, Paul KligfieldRichard Lockwood, Joseph Edward Marine, Robert Benjamin McCully, Joseph V. Messer, Patrick T. O'Gara, Richard J. Shemin, L. Samuel Wann, John B. Wong, Alan S. Brown, Bruce D. Lindsay

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-byside rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram(ECG). Testing for the evaluation of newor worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patientswho had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECGwas suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.

Original languageEnglish (US)
Pages (from-to)65-90
Number of pages26
JournalJournal of Cardiac Failure
Volume20
Issue number2
DOIs
StatePublished - Feb 2014

Fingerprint

Myocardial Ischemia
Exercise
Prescriptions
Heart Failure
Calcium
Transplants
Stress Echocardiography
Syncope
Percutaneous Coronary Intervention
Coronary Angiography
Practice Guidelines
Coronary Artery Bypass
Radionuclide Imaging
Blood Vessels
Cardiac Arrhythmias
Electrocardiography
Magnetic Resonance Spectroscopy
Cardiac Rehabilitation

Keywords

  • ACCF Appropriate Use Criteria
  • appropriateness criteria
  • imaging
  • ischemic heart disease
  • multimodality
  • SIHD

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. / Wolk, Michael J.; Bailey, Steven R; Doherty, John U.; Douglas, Pamela S.; Hendel, Robert C.; Kramer, Christopher M.; Min, James K.; Patel, Manesh R.; Rosenbaum, Lisa; Shaw, Leslee J.; Stainback, Raymond F.; Allen, Joseph M.; Brindis, Ralph G.; Cerqueira, Manuel D.; Chen, Jersey; Dean, Larry S.; Fazel, Reza; Hundley, W. Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V.; O'Gara, Patrick T.; Shemin, Richard J.; Wann, L. Samuel; Wong, John B.; Brown, Alan S.; Lindsay, Bruce D.

In: Journal of Cardiac Failure, Vol. 20, No. 2, 02.2014, p. 65-90.

Research output: Contribution to journalArticle

Wolk, MJ, Bailey, SR, Doherty, JU, Douglas, PS, Hendel, RC, Kramer, CM, Min, JK, Patel, MR, Rosenbaum, L, Shaw, LJ, Stainback, RF, Allen, JM, Brindis, RG, Cerqueira, MD, Chen, J, Dean, LS, Fazel, R, Hundley, WG, Itchhaporia, D, Kligfield, P, Lockwood, R, Marine, JE, McCully, RB, Messer, JV, O'Gara, PT, Shemin, RJ, Wann, LS, Wong, JB, Brown, AS & Lindsay, BD 2014, 'ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease', Journal of Cardiac Failure, vol. 20, no. 2, pp. 65-90. https://doi.org/10.1016/j.cardfail.2013.12.002
Wolk, Michael J. ; Bailey, Steven R ; Doherty, John U. ; Douglas, Pamela S. ; Hendel, Robert C. ; Kramer, Christopher M. ; Min, James K. ; Patel, Manesh R. ; Rosenbaum, Lisa ; Shaw, Leslee J. ; Stainback, Raymond F. ; Allen, Joseph M. ; Brindis, Ralph G. ; Cerqueira, Manuel D. ; Chen, Jersey ; Dean, Larry S. ; Fazel, Reza ; Hundley, W. Gregory ; Itchhaporia, Dipti ; Kligfield, Paul ; Lockwood, Richard ; Marine, Joseph Edward ; McCully, Robert Benjamin ; Messer, Joseph V. ; O'Gara, Patrick T. ; Shemin, Richard J. ; Wann, L. Samuel ; Wong, John B. ; Brown, Alan S. ; Lindsay, Bruce D. / ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. In: Journal of Cardiac Failure. 2014 ; Vol. 20, No. 2. pp. 65-90.
@article{b71f5ad7e7a14ba79d6484f918fd3172,
title = "ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease",
abstract = "The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-byside rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram(ECG). Testing for the evaluation of newor worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patientswho had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECGwas suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.",
keywords = "ACCF Appropriate Use Criteria, appropriateness criteria, imaging, ischemic heart disease, multimodality, SIHD",
author = "Wolk, {Michael J.} and Bailey, {Steven R} and Doherty, {John U.} and Douglas, {Pamela S.} and Hendel, {Robert C.} and Kramer, {Christopher M.} and Min, {James K.} and Patel, {Manesh R.} and Lisa Rosenbaum and Shaw, {Leslee J.} and Stainback, {Raymond F.} and Allen, {Joseph M.} and Brindis, {Ralph G.} and Cerqueira, {Manuel D.} and Jersey Chen and Dean, {Larry S.} and Reza Fazel and Hundley, {W. Gregory} and Dipti Itchhaporia and Paul Kligfield and Richard Lockwood and Marine, {Joseph Edward} and McCully, {Robert Benjamin} and Messer, {Joseph V.} and O'Gara, {Patrick T.} and Shemin, {Richard J.} and Wann, {L. Samuel} and Wong, {John B.} and Brown, {Alan S.} and Lindsay, {Bruce D.}",
year = "2014",
month = "2",
doi = "10.1016/j.cardfail.2013.12.002",
language = "English (US)",
volume = "20",
pages = "65--90",
journal = "Journal of Cardiac Failure",
issn = "1071-9164",
publisher = "Churchill Livingstone",
number = "2",

}

TY - JOUR

T1 - ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease

AU - Wolk, Michael J.

AU - Bailey, Steven R

AU - Doherty, John U.

AU - Douglas, Pamela S.

AU - Hendel, Robert C.

AU - Kramer, Christopher M.

AU - Min, James K.

AU - Patel, Manesh R.

AU - Rosenbaum, Lisa

AU - Shaw, Leslee J.

AU - Stainback, Raymond F.

AU - Allen, Joseph M.

AU - Brindis, Ralph G.

AU - Cerqueira, Manuel D.

AU - Chen, Jersey

AU - Dean, Larry S.

AU - Fazel, Reza

AU - Hundley, W. Gregory

AU - Itchhaporia, Dipti

AU - Kligfield, Paul

AU - Lockwood, Richard

AU - Marine, Joseph Edward

AU - McCully, Robert Benjamin

AU - Messer, Joseph V.

AU - O'Gara, Patrick T.

AU - Shemin, Richard J.

AU - Wann, L. Samuel

AU - Wong, John B.

AU - Brown, Alan S.

AU - Lindsay, Bruce D.

PY - 2014/2

Y1 - 2014/2

N2 - The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-byside rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram(ECG). Testing for the evaluation of newor worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patientswho had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECGwas suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.

AB - The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-byside rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram(ECG). Testing for the evaluation of newor worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patientswho had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECGwas suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.

KW - ACCF Appropriate Use Criteria

KW - appropriateness criteria

KW - imaging

KW - ischemic heart disease

KW - multimodality

KW - SIHD

UR - http://www.scopus.com/inward/record.url?scp=84894577152&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84894577152&partnerID=8YFLogxK

U2 - 10.1016/j.cardfail.2013.12.002

DO - 10.1016/j.cardfail.2013.12.002

M3 - Article

C2 - 24556531

AN - SCOPUS:84894577152

VL - 20

SP - 65

EP - 90

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

SN - 1071-9164

IS - 2

ER -