Testing Real-World Application of Appropriateness Criteria of Single Photon Emission Computed Tomography (SPECT) In Two Egyptian Hospitals

BACKGROUND: The American College of Cardiology pioneered appropriateness criteria for single-photon emission computed tomography myocardial perfusion imaging in 2005 to account for evidence-based clinical relevance of stress perfusion imaging. Our aim was to assess and compare appropriateness use criteria in in Kobry al Kobba military hospital and Ain Shams University hospitals. METHODS: All patients were subjected to thorough history taking, calculation of pretest probability and Framingham risk score, determination of appropriateness use criteria and stress-rest Tc 99m imaging to detect the presence of ischemia and one day Tc 99m imaging to detect viability. RESULTS: The study included 442 patients with mean age of 56.5 years, with male predominance (77%), 38% were diabetics and 58% had hypertension. Seventy-eight percent of patients had appropriate tests, uncertain tests in 12% and 10% inappropriate studies. 47% of appropriate tests show positive results of SPECT. CONCLUSION: We concluded that appropriateness criteria are effective in identifying appropriateness of SPECT in a diverse patient population.