There is increased competition between specialists now that imaging technology is such that various modalities and tests can be used to diagnose cardiovascular illness. However, the European Society of Cardiology (ESC) believes that this situation could also spawn collaborations between specialists in different modality areas.
The ESC, which represents 45,000 cardiology professionals across Europe and the Mediterranean, has written a paper titled "The future of cardiovascular imaging and non-invasive diagnosis" which addresses this interdisciplinary collaboration issue.
The major recommendations in the paper include:
- Cardiac units should develop joint clinical services with common diagnostic pathways for patients with suspected cardiovascular disease, which are organized in collaboration between cardiologists, radiologists, and specialists in nuclear medicine. This will require reorganization of traditional hospital structures and a new way of working;
- Future diagnostic specialists in cardiology should be trained in several imaging modalities;
- Diagnostic tests should be evaluated by their impact on clinical outcomes, rather than their ability to provide better pictures or more diagnostic information. Different tests vary widely in their technical requirements, benefits, limitations, and costs. Surprisingly, relatively little is known about which diagnostic tests most favorably change the course of an illness, when clinical decisions are based on the findings of the test. At the same time, most diagnostic tests are imperfect - they cannot always give the correct answer;
- Diagnostic guidelines should compare all methods that can be applied to a particular clinical question. Clinical doctors need impartial expert advice that summarizes and compares all the alternative tests;
- New criteria need to be developed for judging the quality of diagnostic research; and
- Expertise in clinical diagnosis and imaging needs to be encouraged in universities, and funding should be available for research in diagnostic methods as an integral component of basic, epidemiological and clinical collaborative research networks.
"Advances in imaging technology now provide a wonderful spectrum of diagnostic tools to investigate heart and vascular disease, but much less is known about which test performs best in which circumstances and which test might have the greatest impact on improving treatment" said Alan Fraser, president of the European Association of Echocardiography. "There is an urgent need for collaboration between experts in different techniques, with appropriate research funding, to establish how these expensive tools can best be used to provide the greatest benefits to patients and to reduce health care costs".
The full statement is available here: http://eurheartj.oxfordjournals.org/cgi/reprint/27/14/1750