251. ACR Appropriateness Criteria.sup.[R] Dyspnea--Suspected Cardiac Origin
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Vogel-Claussen, Jens, Elshafee, Amany S.M., Kirsch, Jacobo, Brown, Richard K.J., Hurwitz, Lynne M., Javidan-Nejad, Cylen, Julsrud, Paul R., Kramer, Christopher M., Krishnamurthy, Rajesh, Laroia, Archana T., Leipsic, Jonathon A., Panchal, Kalpesh K., Shah, Amar B., White, Richard D., Woodard, Pamela K., and Abbara, Suhny
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Heart failure ,Decision-making ,Heart ,Health - Abstract
To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1016/j.jacr.2017.01.032 Byline: Jens Vogel-Claussen, MD [jclauss1@jhmi.edu] (a,*), Amany S.M. Elshafee, BCh, MB (b), Jacobo Kirsch, MD (c), Richard K.J. Brown, MD (d), Lynne M. Hurwitz, MD (e), Cylen Javidan-Nejad, MD (f), Paul R. Julsrud, MD (g), Christopher M. Kramer, MD (h), Rajesh Krishnamurthy, MD (i), Archana T. Laroia, MD (j), Jonathon A. Leipsic, MD (k), Kalpesh K. Panchal, MD (l), Amar B. Shah, MD (m), Richard D. White, MD (n), Pamela K. Woodard, MD (o), Suhny Abbara, MD (p) Expert Panel on Cardiac Imaging: Key Words Appropriateness Criteria; Appropriate Use Criteria; AUC; cardiac arrhythmia; dyspnea; heart failure; ischemia; pericardial disease; valvular heart disease Abstract This article discusses imaging guidelines for five dyspnea variants: (1) dyspnea due to heart failure, ischemia not excluded; (2) dyspnea due to suspected nonischemic heart failure, ischemia excluded; (3) dyspnea due to suspected valvular heart disease, ischemia excluded; (4) dyspnea due to suspected cardiac arrhythmia, ischemia excluded; and (5) dyspnea due to suspected pericardial disease, ischemia excluded. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Author Affiliation: (a) Principal Author, Johns Hopkins Hospital, Baltimore, Maryland, and Medizinische Hochschule Hannover, Hannover, Germany (b) Research Author, Medizinische Hochschule Hannover, Hannover, Germany, and Mansoura University Hospitals, Mansoura, Egypt (c) Cleveland Clinic Florida, Weston, Florida (d) University Hospital, Ann Arbor, Michigan (e) Duke University Medical Center, Durham, North Carolina (f) Mallinckrodt Institute of Radiology; Washington University School of Medicine, Saint Louis, Missouri (g) Mayo Clinic, Rochester, Minnesota (h) University of Virginia Health System, Charlottesville, Virginia; American College of Cardiology (i) Nationwide Children's Hospital, Columbus, Ohio (j) University of Iowa Hospitals and Clinics, Iowa City, Iowa (k) St. Paul's Hospital, Vancouver, British Columbia, Canada (l) University of Cincinnati Hospital, Cincinnati, Ohio (m) Westchester Medical Center, Valhalla, New York (n) The Ohio State University Wexner Medical Center, Columbus, Ohio (o) Specialty Chair, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Saint Louis, Missouri (p) Panel Chair, UT Southwestern Medical Center, Dallas, Texas * Corresponding author: Jens Vogel-Claussen, MD, Department of Radiology, JHOC, Johns Hopkins Hospital, 601 N Caroline Street, Baltimore, MD 21287-0006. (footnote) The American College of Radiology seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply individual or society endorsement of the final document. (footnote) Reprint requests: publications@acr.org (footnote) Dr. Vogel-Claussen reports grants and personal fees from Novartis, grants from Boehringer Ingelheim, grants from Siemens, personal fees from Parexel, outside the submitted work. Dr. Kramer reports personal fees from Bayer, outside the submitted work; Dr. Jonathon A. Leipsic reports personal fees from Speaker's Bureau GE Healthcare. The other authors have no conflicts of interest related to the material discussed in this article. (footnote) Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.
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- 2017
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