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Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US
BACKGROUND: There are limited data on the impact of imaging modality selection for the assessment of coronary artery disease (CAD) risk on downstream resource utilisation. This study sought to identify differences between patient populations in the US undergoing stress echocardiography, single-photo...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186749/ https://www.ncbi.nlm.nih.gov/pubmed/37189049 http://dx.doi.org/10.1186/s12872-023-03218-7 |
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author | Pelletier-Galarneau, Matthieu Vandenbroucke, Emily Lu, Minyi Li, Olivia |
author_facet | Pelletier-Galarneau, Matthieu Vandenbroucke, Emily Lu, Minyi Li, Olivia |
author_sort | Pelletier-Galarneau, Matthieu |
collection | PubMed |
description | BACKGROUND: There are limited data on the impact of imaging modality selection for the assessment of coronary artery disease (CAD) risk on downstream resource utilisation. This study sought to identify differences between patient populations in the US undergoing stress echocardiography, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), positron emission tomography (PET) MPI, and coronary computed tomography angiography (cCTA) for the assessment of CAD risk, and associated physician referral patterns. METHODS: Claims and electronic health records data for 2.5 million US patients who received stress echocardiography, cCTA, SPECT MPI or PET MPI between January 2016 and March 2018, from the Decision Resources Group Real-World Evidence US Data Repository, were analysed. Patients were stratified into suspected and existing CAD cohorts, and further stratified by pre-test risk and presence and recency of interventions or acute cardiac events (within 1–2 years pre-index test). Linear and logistic regression were used to compare numeric and categorical variables. RESULTS: Physicians were more likely to refer patients to standalone SPECT MPI (77%) and stress echocardiography (18%) than PET MPI (3%) and cCTA (2%). Overall, 43% of physicians referred more than 90% of their patients to standalone SPECT MPI. Just 3%, 1% and 1% of physicians referred more than 90% of their patients to stress echocardiography, PET MPI or cCTA. At the aggregated imaging level, patients who underwent stress echocardiography or cCTA had similar comorbidity profiles. Comorbidity profiles were also similar for patients who underwent SPECT MPI and PET MPI. CONCLUSION: Most patients underwent SPECT MPI at the index date, with very few undergoing PET MPI or cCTA. Patients who underwent cCTA at the index date were more likely to undergo additional imaging tests compared with those who underwent other imaging modalities. Further evidence is needed to understand factors influencing imaging test selection across patient populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03218-7. |
format | Online Article Text |
id | pubmed-10186749 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101867492023-05-17 Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US Pelletier-Galarneau, Matthieu Vandenbroucke, Emily Lu, Minyi Li, Olivia BMC Cardiovasc Disord Research BACKGROUND: There are limited data on the impact of imaging modality selection for the assessment of coronary artery disease (CAD) risk on downstream resource utilisation. This study sought to identify differences between patient populations in the US undergoing stress echocardiography, single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), positron emission tomography (PET) MPI, and coronary computed tomography angiography (cCTA) for the assessment of CAD risk, and associated physician referral patterns. METHODS: Claims and electronic health records data for 2.5 million US patients who received stress echocardiography, cCTA, SPECT MPI or PET MPI between January 2016 and March 2018, from the Decision Resources Group Real-World Evidence US Data Repository, were analysed. Patients were stratified into suspected and existing CAD cohorts, and further stratified by pre-test risk and presence and recency of interventions or acute cardiac events (within 1–2 years pre-index test). Linear and logistic regression were used to compare numeric and categorical variables. RESULTS: Physicians were more likely to refer patients to standalone SPECT MPI (77%) and stress echocardiography (18%) than PET MPI (3%) and cCTA (2%). Overall, 43% of physicians referred more than 90% of their patients to standalone SPECT MPI. Just 3%, 1% and 1% of physicians referred more than 90% of their patients to stress echocardiography, PET MPI or cCTA. At the aggregated imaging level, patients who underwent stress echocardiography or cCTA had similar comorbidity profiles. Comorbidity profiles were also similar for patients who underwent SPECT MPI and PET MPI. CONCLUSION: Most patients underwent SPECT MPI at the index date, with very few undergoing PET MPI or cCTA. Patients who underwent cCTA at the index date were more likely to undergo additional imaging tests compared with those who underwent other imaging modalities. Further evidence is needed to understand factors influencing imaging test selection across patient populations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12872-023-03218-7. BioMed Central 2023-05-15 /pmc/articles/PMC10186749/ /pubmed/37189049 http://dx.doi.org/10.1186/s12872-023-03218-7 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Pelletier-Galarneau, Matthieu Vandenbroucke, Emily Lu, Minyi Li, Olivia Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title | Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title_full | Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title_fullStr | Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title_full_unstemmed | Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title_short | Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US |
title_sort | characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the us |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10186749/ https://www.ncbi.nlm.nih.gov/pubmed/37189049 http://dx.doi.org/10.1186/s12872-023-03218-7 |
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