Think Tank releases initial guidelines to improve heart imaging

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A think tank formed to develop a plan for improving the use of imaging technologies in patients with cardiovascular disease has released its recommendations to improve the exams. The recommendation — originally reported in the Nov. 14, 2006, issue of the Journal of the American College of Cardiology — are designed to hopefully improve outcomes, patient quality of life, and bring down treatment expenses.

There are a few imaging technologies generally used to help diagnose heart problems, and these techniques include noninvasive tests such as ultrasound, CT scans and magnetic resonance imaging. Others include more invasive tests such as angiography which uses ultrasound to track the movement of dyes in a patient’s heart.

"Cardiovascular imaging has enjoyed both rapid technological advances and sustained growth, yet less attention has been focused on quality than in other areas of cardiovascular medicine,” said Pamela Douglas, MD, chief of cardiovascular medicine at Duke, past president of the American College of Cardiology and first author of the journal report. "We believe there is good reason to change the debate from how to cut costs to how to provide the best value to patients.”

Douglas said that the panel, known as American College of Cardiology-Duke University Medical Center Think Tank on Quality in Cardiovascular Imaging, was assembled to come up with consensus definitions of quality and then develop strategies to measure and achieve these goals.

The group's proposed action plan represents a first step, Douglas said, with more detailed quality guidelines within the next 18 months.

The panel looked at four broad aspects of heart imaging: matching patients with the best imaging technique, acquiring the best images, correctly interpreting the images and communicating the results of the tests to the patients' physicians.

As a first step, the panel recommended that standardized methods be developed for collecting and analyzing data and for communicating the findings back to referring physicians.

The panel also agreed that standard protocols and procedures need to be developed and followed to ensure that images be of uniformly high quality regardless of test location. Also, technicians should receive advanced training or certification in their areas.

Also, the panel said, physicians who read and interpret the images must be certified by their respective credentialing societies. Moreover, independent groups should be established to conduct regular reviews of physicians' interpretations to determine if the correct interpretation was made. Comparative studies using databases of standardized images also could help ensure that the correct interpretation was made, the panel said.