应力单光子发射计算机断层扫描的适当使用标准: 六合研究:质量改进项目
Raymond J Gibbons1, J Wells Askew, David Hodge
1Mayo Foundation, 200 First Street SW, Rochester, MN 55905, USA. gibbons.raymond@mayo.edu
Circulation
|January 26, 2011
概括
医生教育的努力并没有减少不适当的压力单光子发射计算机断层扫描 (SPECT) 成像率. 需要进一步的干预,以改善在心脏成像中遵守适当的使用标准.
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 提高质量 提高质量
背景情况:
- 之前的报告详细介绍了2005年ACCF对压力单光子发射计算机断层扫描 (SPECT) 成像的适当使用标准的应用.
- 一项质量改进倡议侧重于医生教育,以减少不适当的SPECT研究.
研究的目的:
- 评估医生教育干预措施对减少不适当压力的有效性.SPECT成像.
主要方法:
- 一个质量改进项目涉及大型圆形演示,新闻通讯出版和部门会议.
- 2008年,使用已知方法重新评估了SPECT研究的适当性.
- 对比了2005年,2006年和2008年的研究指示和患者队列.
主要成果:
- 不合适的SPECT研究从2005年的14.4%下降到2006年的7.0%.
- 在2008年医生教育干预之后,不合适的研究增加到11.7%.
- 观察到总体适当性分类变化的趋势 (P=0.08),随着时间的推移,不适当的研究率发生了显著变化 (P=0.018).
结论:
- 质量改进项目,包括医生教育,没有有效地减少不适当的压力SPECT研究.
- 仅限于医生教育等有限的干预措施可能只能提供最小的益处.
- 可能需要更全面的干预措施来加强对心脏成像的适当性标准的遵守.
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