ACR Appropriateness Criteria(®) Neuroendocrine Imaging.
Diagnosis Differential; Humans; United States; Evidence-Based Medicine; Contrast Media; Societies Medical; Apoplexy; Appropriate Use Criteria; Appropriateness Criteria; AUC; Diabetes insipidus; Pituitary; Pituitary adenoma; Pituitary Diseases/diagnostic imaging; Precocious puberty; Sella turcica
Neuroendocrine dysfunction includes suspected hyper- and hypofunction of the pituitary gland. Causative lesions may include primary masses of the pituitary such as pituitary microadenomas and macroadenomas, as well as extrinsic masses, typically centered in the suprasellar cistern. Clinical syndromes related to hormonal dysfunction can be caused by excessive hormonal secretion or by inhibited secretion due to mass effect upon elements of the hypothalamic-pituitary axis. Additionally, complications such as hemorrhage may be seen in the setting of an underlying mass and can result in hormonal dysfunction. MRI with high-resolution protocols is the best first-line test to evaluate the sella turcica and parasellar region. CT provides complementary information regarding bony anatomy, and may be appropriate as a first-line test in certain instances, but it provides less detail and lesion characterization when compared to MRI. 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.
Burns J; Policeni B; Bykowski J; Dubey P; Germano IM; Jain V; Juliano AF; Moonis G; Parsons MS; Powers WJ; Rath TJ; Schroeder JW; Subramaniam RM; Taheri MR; Whitehead MT; Zander D; Corey A
Journal of the American College of Radiology
2019
2019-05
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1016/j.jacr.2019.02.017" target="_blank" rel="noreferrer noopener">10.1016/j.jacr.2019.02.017</a>
Harmonized outcome measures for use in atrial fibrillation patient registries and clinical practice: Endorsed by the Heart Rhythm Society Board of Trustees.
Humans; Risk Factors; United States/epidemiology; Survival Rate/trends; Cardiology; Morbidity/trends; Risk Assessment/methods; Atrial fibrillation; Common data element; Data standard; Harmonization; Outcome measure; Patient outcome; Patient registry; Registries; Societies Medical; Atrial Fibrillation/complications/epidemiology; Outcome Assessment Health Care/methods; Stroke/epidemiology/etiology
BACKGROUND: Atrial fibrillation (AF) affects an estimated 33 million people worldwide, leading to increased mortality and an increased risk of heart failure and stroke. Many AF patient registries exist, but the ability to link and compare data across registries is hindered by differences in the outcome measures collected by each registry and a lack of harmonization. OBJECTIVES: The purpose of this project was to develop a minimum set of standardized outcome measures that could be collected in AF patient registries and clinical practice. METHODS: AF patient registries were identified through multiple sources and invited to join the workgroup and submit outcome measures. Additional measures were identified through literature searches and reviews of consensus statements. Outcome measures were categorized using the Agency for Healthcare Research and Quality's supported Outcome Measures Framework (OMF). A minimum set of broadly relevant measures was identified. Measure definitions were harmonized through in-person and virtual meetings. RESULTS: One hundred twelve outcome measures, including those from thirteen registries, were curated according to the OMF and then harmonized into a minimum set of measures in the OMF categories of survival (3 measures), clinical response (3 measures), events of interest (9 measures), patient-reported outcomes (2 measures), and resource utilization (3 measures). The harmonized definitions build on existing consensus statements. CONCLUSIONS: The harmonized measures represent a minimum set of outcomes that are relevant in AF research and clinical practice. Routine and consistent collection of these measures in registries and in other systems would support creation of a research infrastructure to efficiently address new questions and improve patient outcomes.
Calkins H; Gliklich RE; Leavy MB; Piccini JP; Hsu JC; Mohanty S; Lewis W; Nazarian S; Turakhia MP
Heart Rhythm
2019
2019-01
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.1016/j.hrthm.2018.09.021" target="_blank" rel="noreferrer noopener">10.1016/j.hrthm.2018.09.021</a>