Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization
We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease ( N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was obse...
Gespeichert in:
| Veröffentlicht in: | Journal of chronic diseases 1987, Vol.40 (5), p.385-397 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 397 |
|---|---|
| container_issue | 5 |
| container_start_page | 385 |
| container_title | Journal of chronic diseases |
| container_volume | 40 |
| creator | Wassertheil-Smoller, Sylvia Steingart, Richard M. Wexler, John P. Tobin, Jonathan Budner, Nancy Wachspress, Joseph Lense, Lloyd Slagle, Susan |
| description | We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease (
N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was observed in 31% of cases. Catheterization rates were reduced by 25% among patients referred for resting studies and by 49% for exercise studies (thallium perfusion or exercise wall motion studies). Results of CVNMS had little impact on catheterization decisions for resting study patients (
N = 192). Among exercise study patients (
N = 247), those with normal results had a relative reduction in catheterization post-CVNMS of 82% vs 27% for patients with abnormal results (
p < 0.001). However, impact of exercise CVNMS test results on post-CVNMS catheterization rates obtained for men only; women with abnormal exercise study results were much less likely to undergo subsequent catheterization (7.7%) than men with abnormal results (41.9%),
p < 0.005, independent of age. The apparent discrepancy in referral for catheterization based on sex needs to be investigated further. |
| doi_str_mv | 10.1016/0021-9681(87)90172-X |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_77462676</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>002196818790172X</els_id><sourcerecordid>77462676</sourcerecordid><originalsourceid>FETCH-LOGICAL-c357t-f6ceb6da1e6f78767cf41afcfa79cf81bc768ce77201a8369d133a5765c2641b3</originalsourceid><addsrcrecordid>eNp9kMtOxDAMRbMA8f4DkLJCsCg0fcQpC6QR4iUh2IDELmQcBwKdFpIWCb6eDDNiycq6tu-1fBjbFfmRyIU8zvNCZI1U4kDBYZMLKLLHFbbx115nmzG-Jqmqullja2VdKxCwwZ5uR2zJBB7RdPGETzi2vvNoWm4JffR9x2fmzXfPfOj7lg8vZuCB7IgUkyDeEVnu-sDRBOsNppraAwX_bYbk3marzrSRdpZ1iz1cnN-fXWU3d5fXZ5ObDMsahsxJpKm0RpB0oEACukoYh85Ag06JKYJUSABFLowqZWNFWZoaZI2FrMS03GL7i9z30H-MFAc98xGpbU1H_Rg1QCULCTItVotFDH2MgZx-D35mwpcWuZ7D1HNqek5NK9C_MPVjsu0t88fpjOyfaUkyzU8Xc0pPfnoKOqKnDsn6QDho2_v_D_wABaWG4Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>77462676</pqid></control><display><type>article</type><title>Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Wassertheil-Smoller, Sylvia ; Steingart, Richard M. ; Wexler, John P. ; Tobin, Jonathan ; Budner, Nancy ; Wachspress, Joseph ; Lense, Lloyd ; Slagle, Susan</creator><creatorcontrib>Wassertheil-Smoller, Sylvia ; Steingart, Richard M. ; Wexler, John P. ; Tobin, Jonathan ; Budner, Nancy ; Wachspress, Joseph ; Lense, Lloyd ; Slagle, Susan</creatorcontrib><description>We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease (
N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was observed in 31% of cases. Catheterization rates were reduced by 25% among patients referred for resting studies and by 49% for exercise studies (thallium perfusion or exercise wall motion studies). Results of CVNMS had little impact on catheterization decisions for resting study patients (
N = 192). Among exercise study patients (
N = 247), those with normal results had a relative reduction in catheterization post-CVNMS of 82% vs 27% for patients with abnormal results (
p < 0.001). However, impact of exercise CVNMS test results on post-CVNMS catheterization rates obtained for men only; women with abnormal exercise study results were much less likely to undergo subsequent catheterization (7.7%) than men with abnormal results (41.9%),
p < 0.005, independent of age. The apparent discrepancy in referral for catheterization based on sex needs to be investigated further.</description><identifier>ISSN: 0021-9681</identifier><identifier>DOI: 10.1016/0021-9681(87)90172-X</identifier><identifier>PMID: 3558717</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Cardiac Catheterization ; Coronary Disease - diagnostic imaging ; Decision Making ; Evaluation Studies as Topic ; Exercise Test ; Female ; Humans ; Male ; Middle Aged ; Radioisotopes ; Radionuclide Imaging ; Referral and Consultation ; Regression Analysis ; Sex Factors ; Thallium</subject><ispartof>Journal of chronic diseases, 1987, Vol.40 (5), p.385-397</ispartof><rights>1987</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-f6ceb6da1e6f78767cf41afcfa79cf81bc768ce77201a8369d133a5765c2641b3</citedby><cites>FETCH-LOGICAL-c357t-f6ceb6da1e6f78767cf41afcfa79cf81bc768ce77201a8369d133a5765c2641b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4024,27923,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3558717$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wassertheil-Smoller, Sylvia</creatorcontrib><creatorcontrib>Steingart, Richard M.</creatorcontrib><creatorcontrib>Wexler, John P.</creatorcontrib><creatorcontrib>Tobin, Jonathan</creatorcontrib><creatorcontrib>Budner, Nancy</creatorcontrib><creatorcontrib>Wachspress, Joseph</creatorcontrib><creatorcontrib>Lense, Lloyd</creatorcontrib><creatorcontrib>Slagle, Susan</creatorcontrib><title>Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization</title><title>Journal of chronic diseases</title><addtitle>J Chronic Dis</addtitle><description>We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease (
N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was observed in 31% of cases. Catheterization rates were reduced by 25% among patients referred for resting studies and by 49% for exercise studies (thallium perfusion or exercise wall motion studies). Results of CVNMS had little impact on catheterization decisions for resting study patients (
N = 192). Among exercise study patients (
N = 247), those with normal results had a relative reduction in catheterization post-CVNMS of 82% vs 27% for patients with abnormal results (
p < 0.001). However, impact of exercise CVNMS test results on post-CVNMS catheterization rates obtained for men only; women with abnormal exercise study results were much less likely to undergo subsequent catheterization (7.7%) than men with abnormal results (41.9%),
p < 0.005, independent of age. The apparent discrepancy in referral for catheterization based on sex needs to be investigated further.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Cardiac Catheterization</subject><subject>Coronary Disease - diagnostic imaging</subject><subject>Decision Making</subject><subject>Evaluation Studies as Topic</subject><subject>Exercise Test</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Radioisotopes</subject><subject>Radionuclide Imaging</subject><subject>Referral and Consultation</subject><subject>Regression Analysis</subject><subject>Sex Factors</subject><subject>Thallium</subject><issn>0021-9681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1987</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtOxDAMRbMA8f4DkLJCsCg0fcQpC6QR4iUh2IDELmQcBwKdFpIWCb6eDDNiycq6tu-1fBjbFfmRyIU8zvNCZI1U4kDBYZMLKLLHFbbx115nmzG-Jqmqullja2VdKxCwwZ5uR2zJBB7RdPGETzi2vvNoWm4JffR9x2fmzXfPfOj7lg8vZuCB7IgUkyDeEVnu-sDRBOsNppraAwX_bYbk3marzrSRdpZ1iz1cnN-fXWU3d5fXZ5ObDMsahsxJpKm0RpB0oEACukoYh85Ag06JKYJUSABFLowqZWNFWZoaZI2FrMS03GL7i9z30H-MFAc98xGpbU1H_Rg1QCULCTItVotFDH2MgZx-D35mwpcWuZ7D1HNqek5NK9C_MPVjsu0t88fpjOyfaUkyzU8Xc0pPfnoKOqKnDsn6QDho2_v_D_wABaWG4Q</recordid><startdate>1987</startdate><enddate>1987</enddate><creator>Wassertheil-Smoller, Sylvia</creator><creator>Steingart, Richard M.</creator><creator>Wexler, John P.</creator><creator>Tobin, Jonathan</creator><creator>Budner, Nancy</creator><creator>Wachspress, Joseph</creator><creator>Lense, Lloyd</creator><creator>Slagle, Susan</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>1987</creationdate><title>Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization</title><author>Wassertheil-Smoller, Sylvia ; Steingart, Richard M. ; Wexler, John P. ; Tobin, Jonathan ; Budner, Nancy ; Wachspress, Joseph ; Lense, Lloyd ; Slagle, Susan</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-f6ceb6da1e6f78767cf41afcfa79cf81bc768ce77201a8369d133a5765c2641b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1987</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Cardiac Catheterization</topic><topic>Coronary Disease - diagnostic imaging</topic><topic>Decision Making</topic><topic>Evaluation Studies as Topic</topic><topic>Exercise Test</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Radioisotopes</topic><topic>Radionuclide Imaging</topic><topic>Referral and Consultation</topic><topic>Regression Analysis</topic><topic>Sex Factors</topic><topic>Thallium</topic><toplevel>online_resources</toplevel><creatorcontrib>Wassertheil-Smoller, Sylvia</creatorcontrib><creatorcontrib>Steingart, Richard M.</creatorcontrib><creatorcontrib>Wexler, John P.</creatorcontrib><creatorcontrib>Tobin, Jonathan</creatorcontrib><creatorcontrib>Budner, Nancy</creatorcontrib><creatorcontrib>Wachspress, Joseph</creatorcontrib><creatorcontrib>Lense, Lloyd</creatorcontrib><creatorcontrib>Slagle, Susan</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of chronic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wassertheil-Smoller, Sylvia</au><au>Steingart, Richard M.</au><au>Wexler, John P.</au><au>Tobin, Jonathan</au><au>Budner, Nancy</au><au>Wachspress, Joseph</au><au>Lense, Lloyd</au><au>Slagle, Susan</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization</atitle><jtitle>Journal of chronic diseases</jtitle><addtitle>J Chronic Dis</addtitle><date>1987</date><risdate>1987</risdate><volume>40</volume><issue>5</issue><spage>385</spage><epage>397</epage><pages>385-397</pages><issn>0021-9681</issn><abstract>We have assessed the impact of cardiovascular nuclear medicine studies (CVNMS) on physicians' decisions to send patients with suspected ischemic heart disease (
N = 439) on to cardiac catheterization at three Bronx hospitals. A change in management plans with respect to catheterization was observed in 31% of cases. Catheterization rates were reduced by 25% among patients referred for resting studies and by 49% for exercise studies (thallium perfusion or exercise wall motion studies). Results of CVNMS had little impact on catheterization decisions for resting study patients (
N = 192). Among exercise study patients (
N = 247), those with normal results had a relative reduction in catheterization post-CVNMS of 82% vs 27% for patients with abnormal results (
p < 0.001). However, impact of exercise CVNMS test results on post-CVNMS catheterization rates obtained for men only; women with abnormal exercise study results were much less likely to undergo subsequent catheterization (7.7%) than men with abnormal results (41.9%),
p < 0.005, independent of age. The apparent discrepancy in referral for catheterization based on sex needs to be investigated further.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>3558717</pmid><doi>10.1016/0021-9681(87)90172-X</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0021-9681 |
| ispartof | Journal of chronic diseases, 1987, Vol.40 (5), p.385-397 |
| issn | 0021-9681 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_77462676 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Cardiac Catheterization Coronary Disease - diagnostic imaging Decision Making Evaluation Studies as Topic Exercise Test Female Humans Male Middle Aged Radioisotopes Radionuclide Imaging Referral and Consultation Regression Analysis Sex Factors Thallium |
| title | Nuclear scans: A clinical decision making tool that reduces the need for cardiac catheterization |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-28T08%3A21%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Nuclear%20scans:%20A%20clinical%20decision%20making%20tool%20that%20reduces%20the%20need%20for%20cardiac%20catheterization&rft.jtitle=Journal%20of%20chronic%20diseases&rft.au=Wassertheil-Smoller,%20Sylvia&rft.date=1987&rft.volume=40&rft.issue=5&rft.spage=385&rft.epage=397&rft.pages=385-397&rft.issn=0021-9681&rft_id=info:doi/10.1016/0021-9681(87)90172-X&rft_dat=%3Cproquest_cross%3E77462676%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=77462676&rft_id=info:pmid/3558717&rft_els_id=002196818790172X&rfr_iscdi=true |