Evidence map›Paper›PMID 31741326›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2021

Appropriateness of inpatient stress testing: Implications for development of clinical decision support mechanisms and future criteria.

Sanjay Divakaran, Avinainder Singh, Ersilia M DeFilippis, Timothy W Churchill, Sarah Cuddy, Yin Ge, Ivan K Ip, Wunan Zhou, Hicham Skali, Viviany R Taqueti and 8 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. PAMA New Year's 2020: Did everything get brought to the party?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2021
    Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Sanjay DivakaranCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Avinainder SinghDepartment of Medicine, Yale University School of Medicine, New Haven, CT, USA.
Ersilia M DeFilippisDivision of Cardiology, Department of Medicine, New York Presbyterian-Columbia University Irving Medical Center, New York, NY, USA.
Timothy W ChurchillDivision of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Sarah CuddyCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Yin GeCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ivan K IpAstellas Pharma Global Development, Inc, Northbrook, IL, USA.
Wunan ZhouCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Hicham SkaliCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Viviany R TaquetiCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Sharmila DorbalaCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
James SpaldingAstellas Pharma Global Development, Inc, Northbrook, IL, USA.
Yanqing XuAstellas Pharma Global Development, Inc, Northbrook, IL, USA.
Ramin KhorasaniDepartment of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Marcelo F Di CarliCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Maria A YialamasDepartment of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Ron BlanksteinCardiovascular Imaging Program, Departments of Medicine and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. rblankstein@bwh.harvard.edu.
Brigham and Women’s Hospital Internal Medicine Residency

Funding

Noninvasive Cardiovascular Imaging Research Training ProgramT32HL094301 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI Marcelo F DI CARLI · 2010 to 2026
$7.8M
Molecular Imaging of Primary Amyloid CardiomyopathyR01HL130563 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DORBALA, SHARMILA, FALK, RODNEY H · 2016 to 2019
$3.3M
Coronary Flow Reserve to Assess Cardiovascular Inflammation (CIRT-CFR)R01HL132021 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DI CARLI, MARCELO F · 2016 to 2018
$1.8M
Extension to Coronary Flow Reserve to Assess Hidden Risk: Focus on Women, Heart Failure, and InflammationK23HL135438 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI TAQUETI, VIVIANY R · 2017 to 2021
$1.1M
NHLBI NIH HHS K23 HL135438NHLBI NIH HHS R01 HL130563NHLBI NIH HHS R01 HL132021NHLBI NIH HHS T32 HL094301
6 · The paper itself

Abstract

backgroundAn upcoming national mandate will require consultation of appropriate use criteria (AUC) through a clinical decision support mechanism (CDSM) for advanced imaging. We aimed to evaluate our current ability to ascertain test appropriateness.

methodsWe prospectively collected data on 288 consecutive stress tests and coronary computed tomography angiography studies for medical inpatients. Study appropriateness was determined independently by two physicians using the 2013 Multimodality AUC.

resultsThe median age of the study population was 66 years [interquartile range (IQR) 56, 75], 40.8% were female, and 52.8% had a history of coronary artery disease. Review of the electronic health record (EHR) alone was sufficient to deem appropriateness for 87.2% of cases. The most common reason it was insufficient was inability to determine if the patient could exercise (59.5%). After reviewing the EHR and pilot CDSM data together, appropriateness could be determined for 95.8% of the cases. The most common reason appropriateness could not be determined was that the exam indication was not addressed by an AUC criterion (83.3%).

conclusionIn preparing for the mandate, it will be important for future CDSM to obtain information on the patient's ability to exercise and for future AUC to include additional indications that are not currently addressed.

Indexed as

AgedBostonClinical Decision-MakingCoronary Artery DiseaseExercise TestFemaleHospitalizationHospitalsHumansMaleMiddle AgedCADExercise testingMultimodalityOthers

Identifiers

PMID31741326
PMCPMC7231672

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.