ASCI 2010 Appropriateness Criteria For Cardiac Computed Tomography: A Report of the Asian Society of Cardiovascular Imaging Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging Guideline Working Group

In Asia, the healthcare system, populations and patterns of disease differ from Western countries. The current reports on the criteria for cardiac CT scans, provided by Western professional societies, are not appropriate for Asian cultures. The Asian Society of Cardiovascular Imaging, the only society dedicated to cardiovascular imaging in Asia, formed a Working Group and invited 23 Technical Panel members representing a variety of Asian countries to rate the 51 indications for cardiac CT in clinical practice in Asia. The indications were rated as ‘appropriate’ (7-9), ‘uncertain’ (4-6), or ‘inappropriate’ (1-3) on a scale of 1-9. The median score was used for the final result if there was no disagreement. The final ratings for indications were 33 appropriate, 14 uncertain and 4 inappropriate. And 20 of them are highly agreed (19 appropriate and 1 inappropriate). Specifically, the Asian representatives considered cardiac CT as an appropriate modality for Kawasaki disease and congenital heart diseases in follow up and in symptomatic patients. In addition, except for some specified conditions, cardiac CT was considered to be an appropriate modality for one-stop shop ischemic heart disease evaluation due to its general appropriateness in coronary, structure and function evaluation. This report is expected to have a significant impact on the clinical practice, research and reimbursement policy in Asia. 

PMID: 20094917

Posted in Computed Tomography and tagged , , , , , .

2 Comments

  1. A very interesting document in a search of the Asian proffesional societies to balance between evidence-based medicine or international (mostly American) appropriateness criteria, and the local health care systems needs.
    Some of the readers will not agree with all indications, but the document represent the end result of their work as written by local (and well-known) experts.

  2. Most interesting, but not addressed here, would be to describe the differences in population characteristics and their impact on indications. It is interesting that the two indications highlighted in the abstract (congenital heart diseases and one-stop shop ischemic heart disease evaluation) are controversial or the data preliminary. Also in this context, there is a lack of discussion of radiation exposure (particular in pediatric populations) and discussion of specific protocols, in particular prospective triggering and low tube voltage.

    In all such published guidelines there should be a more vigorous disclosure of conflict of interest. I did not find one here.

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