Results of a Swiss consensus conference on coronary angiography. Members of the Swiss Society of Cardiology, Swiss Society of Internal Medicine, Swiss Society of Thoracic and Cardiovascular Surgery.
Coronary angiography is used as a diagnostic procedure to identify patients with coronary artery disease who need to undergo revascularization. The quality of its indication is widely discussed at present. The Swiss Societies of Cardiology, of Internal Medicine and of Thoracic and Cardiovascular Surgery decided to set up a consensus conference to evaluate the indications for angiography. For this a modified RAND approach (Delphi method) was used. An expert panel rated 374 indications for coronary angiography twice for appropriateness (more benefits than risks for the patient), and once for necessity (procedure has to be offered or discussed with the patient). In the panel an agreement percentage of 54% was noted. In 40% we observed neither agreement nor disagreement and in 6% we found disagreement among the panelists. The necessity ratings showed similar results: 48% agreement, 46% indetermination and 6% disagreement. The average median rating for appropriateness on a 1-9 point scale (1 = extremely inappropriate, 9 = extremely appropriate or necessary) was 6.3 over all given single indications and 7.3 for necessity. The results of appropriateness and necessity ratings presented in this paper reflect the findings of a 15-member Swiss panel.
D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D009204:Myocardial Revascularization; D010348:Patient Care Team; D011785:Quality Assurance, Health Care; D013557:Switzerland