Trends in the Use of Cardiac Imaging for Patients With Heart Failure in Canada
| Autor: | Heather J. Ross, Howard Leong-Poi, Douglas S. Lee, Valeria E. Rac, Peter C. Austin, Juarez R. Braga |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Canada Databases Factual Cross-sectional study Population 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Interquartile range Internal medicine Prevalence medicine Stress Echocardiography Humans Longitudinal Studies 030212 general & internal medicine education Cardiac imaging Aged Original Investigation Aged 80 and over Ontario Heart Failure education.field_of_study medicine.diagnostic_test business.industry Research Health Policy Magnetic resonance imaging Heart General Medicine medicine.disease Magnetic Resonance Imaging 3. Good health Cardiac Imaging Techniques Online Only Cross-Sectional Studies Heart failure Ambulatory Cardiology Female Tomography X-Ray Computed business |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | Key Points Question What is the rate of use and what are the costs of different cardiac imaging modalities used to examine patients with heart failure in Canada? Findings In this repeated cross-sectional study of 882 355 participants in Ontario, Canada, cardiac imaging of heart failure was based predominantly on the use of resting echocardiography, myocardial perfusion scintigraphy, and invasive coronary angiography. After 2011, there was a stabilization in the use of traditional modalities and incorporation of cardiac computed tomography and magnetic resonance imaging. Meaning Provincewide efforts, such as accreditation programs and the adoption of advanced cardiac imaging techniques, may have been associated with changes in physicians’ ordering patterns of cardiac imaging. Importance Cardiac imaging is a component of the provision of medical care for patients with heart failure that has experienced a broad expansion in past decades. However, there is a paucity of studies examining the patterns of use of cardiac imaging modalities in real-world clinical practice. Objectives To investigate temporal trends in the use and costs of cardiac imaging for the examination of patients with heart failure in Canada and to examine the association between the institution of an accreditation program and the use of echocardiography. Design, Setting, and Participants A repeated cross-sectional study based on population-based administrative databases in Ontario, Canada, of individuals with heart failure identified using a validated algorithm based on hospital admissions and ambulatory physician claims was conducted between April 1, 2002, and March 31, 2017. Main Outcomes and Measures The incidence and prevalence of heart failure and the age- and sex-adjusted rate of use and costs of cardiac imaging, including resting and stress echocardiography, myocardial perfusion scintigraphy, invasive coronary angiography, computed tomography, magnetic resonance imaging, and positron emission tomography. Results A total of 882 355 adults (50.1% women; median age, 76 years [interquartile range, 66-83 years]) with prevalent heart failure were identified. The age- and sex-standardized prevalence of heart failure remained stable during the study (2.4% [95% CI, 2.4%-2.4%] in 2002 and 2.0% [95% CI, 2.0%-2.0%] in 2016). There was an increase in the rate of use of resting echocardiography, from 386 tests (95% CI, 373-398) per 1000 patients with heart failure in 2002 to 533 (95% CI, 519-547) per 1000 patients in 2011. Coinciding with the initiation of an accreditation program for echocardiography in 2012, there was an immediate reduction in the rate of use (−59.5 tests per 1000 patients with heart failure; P This cross-sectional study investigates temporal trends in the use and costs of cardiac imaging for patients with heart failure in Canada and examines the association between the institution of an accreditation program and the use of echocardiography. |
| Databáze: | OpenAIRE |
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