Temporal trends in utilization of cardiac computed tomography

Ayyad, Ala-Eddin M.; Cole, Jason; Syed, Asmir; Desai, Milind Y.; Halliburton, Sandra; Schoenhagen, Paul; Flamm, Scott D.; Sola, Srikanth

doi:10.1016/j.jcct.2008.10.009

« Previous Next »Journal of Cardiovascular Computed Tomography
Volume 3, Issue 1 , Pages 16-21, January 2009

Temporal trends in utilization of cardiac computed tomography

Ala-Eddin M. Ayyad, MD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
Jason Cole, MD
- University of South Alabama College of Medicine, Mobile, AL, USA
Asmir Syed, MD
- University of South Alabama College of Medicine, Mobile, AL, USA
Milind Y. Desai, MD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
Sandra Halliburton, PhD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
Paul Schoenhagen, MD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
Scott D. Flamm, MD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
Srikanth Sola, MD
- Cleveland Clinic, Heart and Vascular Institute, Cleveland, OH, USA
- Cleveland Clinic, Imaging Institute, Cleveland, OH, USA
- Corresponding author. Address correspondence to Srikanth Sola, MD, FACC, FAHA, Department of Cardiology, Sri Sathya Sai Institute of Higher Medical Sciences, EPIP Area, Whitefield, Bangalore, 560 066 India.

Received 23 April 2008; accepted 13 October 2008. published online 30 October 2008.

Background

Appropriate, inappropriate, and uncertain indications for the use of cardiac computed tomography (CT) were defined by a multisociety document in 2006. We sought to compare the appropriateness of cardiac CT examinations before and after these criteria were published.

Methods

We retrospectively evaluated all patients presenting for cardiac CT examinations in the first 3 months of 2006 and 2007 at a large academic medical center and an unaffiliated large cardiology group private practice. The indication for the examinations were determined from the patients’ medical records. The examinations were then classified as “appropriate,” “inappropriate,” or “uncertain,” based on appropriateness criteria. Examinations that did not fall into any of these categories were classified as “uncategorized.”

Results

We evaluated a total of 1409 patients (64.9% men; mean age, 57.6 ± 13.4 years). The proportion of appropriate CT examinations increased from 69.5% during the study period in 2006 to 78.5% in 2007 (P = 0.001). A corresponding decrease was observed in inappropriate CT examinations from 11.5% in 2006 to 4.6% in 2007 (P = 0.001). No change was observed in the number of CT examinations that were deemed uncertain (12.7% in 2006, and 13.3% in 2007; P = NS).

Conclusion

The number of CT examinations considered appropriate increased during the study period, whereas the number of inappropriate examinations decreased. Cardiologists were more likely than noncardiologists to order examinations that were appropriate during the study period.

Keywords: Cardiac CT, Computed tomography