Literature DB >> 23143022

Carotid artery stenosis: wide variability in reporting formats--a review of 127 Veterans Affairs medical centers.

Eric M Cheng1, Dawn M Bravata, Suzie El-Saden, Stefanie D Vassar, Susan Ofner, Linda S Williams, Salomeh Keyhani.   

Abstract

PURPOSE: To determine whether radiology reports describe clinically significant carotid arterial stenosis in a consistent format that is actionable by ordering clinicians.
MATERIALS AND METHODS: This study was HIPAA compliant. Informed consent was waived. Institutional review board approval was obtained for this retrospective chart review, which included radiology reports of carotid artery imaging for patients hospitalized with ischemic stroke at 127 Veterans Affairs medical centers in 2006-2007. "Clinically significant results" were defined as results with at least 50% stenosis or at least moderate stenosis, excluding complete occlusion. How often clinically significant results were reported as an exact percentage stenosis (such as 60%), range (such as 50%-69%), or category (such as moderate) was determined. Among results reported as a range, how often the range bracketed clinical thresholds of 50% and 70% (typically used to determine appropriateness of carotid arterial revascularization) was determined.
RESULTS: Among 2675 patients, there were 6618 carotid imaging results, of which 1015 (15%) were considered clinically significant. Among 695 clinically significant results at ultrasonography (US), 348 (50%) were described as a range, and another 314 (45%) were reported as an exact percentage stenosis. Among the 348 clinically significant US results reported as a range, 259 (74%) bracketed the thresholds of 50% or 70%. For magnetic resonance angiographic results, 48% (106 of 221) qualitatively described clinically significant results as a category, 38% (84 of 221) as an exact percentage stenosis, and 14% (31 of 221) as a range.
CONCLUSION: In this national health care system, the manner in which clinically significant carotid arterial stenosis was reported varied widely. RSNA, 2012

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Year:  2012        PMID: 23143022      PMCID: PMC3528970          DOI: 10.1148/radiol.12120453

Source DB:  PubMed          Journal:  Radiology        ISSN: 0033-8419            Impact factor:   11.105


  17 in total

Review 1.  Carotid artery stenosis: gray-scale and Doppler US diagnosis--Society of Radiologists in Ultrasound Consensus Conference.

Authors:  Edward G Grant; Carol B Benson; Gregory L Moneta; Andrei V Alexandrov; J Dennis Baker; Edward I Bluth; Barbara A Carroll; Michael Eliasziw; John Gocke; Barbara S Hertzberg; Sandra Katanick; Laurence Needleman; John Pellerito; Joseph F Polak; Kenneth S Rholl; Douglas L Wooster; R Eugene Zierler
Journal:  Radiology       Date:  2003-09-18       Impact factor: 11.105

2.  Quantification of internal carotid artery stenosis with duplex US: comparative analysis of different flow velocity criteria.

Authors:  Schila Sabeti; Martin Schillinger; Wolfgang Mlekusch; Andrea Willfort; Markus Haumer; Tassilo Nachtmann; Marcus Müllner; Wilfried Lang; Ramazanali Ahmadi; Erich Minar
Journal:  Radiology       Date:  2004-08       Impact factor: 11.105

3.  Sonographic NASCET index: a new doppler parameter for assessment of internal carotid artery stenosis.

Authors:  Gasser M Hathout; James R Fink; Suzie M El-Saden; Edward G Grant
Journal:  AJNR Am J Neuroradiol       Date:  2005-01       Impact factor: 3.825

Review 4.  Non-invasive imaging compared with intra-arterial angiography in the diagnosis of symptomatic carotid stenosis: a meta-analysis.

Authors:  J M Wardlaw; F M Chappell; J J K Best; K Wartolowska; E Berry
Journal:  Lancet       Date:  2006-05-06       Impact factor: 79.321

5.  The radiology report of the future: a summary of the 2007 Intersociety Conference.

Authors:  N Reed Dunnick; Curtis P Langlotz
Journal:  J Am Coll Radiol       Date:  2008-05       Impact factor: 5.532

Review 6.  Carotid endarterectomy--an evidence-based review: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

Authors:  S Chaturvedi; A Bruno; T Feasby; R Holloway; O Benavente; S N Cohen; R Cote; D Hess; J Saver; J D Spence; B Stern; J Wilterdink
Journal:  Neurology       Date:  2005-09-27       Impact factor: 9.910

7.  Randomised trial of endarterectomy for recently symptomatic carotid stenosis: final results of the MRC European Carotid Surgery Trial (ECST)

Authors: 
Journal:  Lancet       Date:  1998-05-09       Impact factor: 79.321

8.  Carotid endarterectomy and the measurement of stenosis.

Authors:  H J Barnett; C P Warlow
Journal:  Stroke       Date:  1993-09       Impact factor: 7.914

9.  Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis.

Authors:  H J M Barnett; D W Taylor; R B Haynes; D L Sackett; S J Peerless; G G Ferguson; A J Fox; R N Rankin; V C Hachinski; D O Wiebers; M Eliasziw
Journal:  N Engl J Med       Date:  1991-08-15       Impact factor: 91.245

10.  Benefit of carotid endarterectomy in patients with symptomatic moderate or severe stenosis. North American Symptomatic Carotid Endarterectomy Trial Collaborators.

Authors:  H J Barnett; D W Taylor; M Eliasziw; A J Fox; G G Ferguson; R B Haynes; R N Rankin; G P Clagett; V C Hachinski; D L Sackett; K E Thorpe; H E Meldrum; J D Spence
Journal:  N Engl J Med       Date:  1998-11-12       Impact factor: 91.245

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  3 in total

Review 1.  Lower extremity CT angiography in peripheral arterial disease: from the established approach to evolving technical developments.

Authors:  Omar Shwaiki; Basem Rashwan; Matthias A Fink; Levester Kirksey; Sameer Gadani; Karunakaravel Karuppasamy; Claudius Melzig; Dustin Thompson; Giuseppe D'Amico; Fabian Rengier; Sasan Partovi
Journal:  Int J Cardiovasc Imaging       Date:  2021-05-17       Impact factor: 2.357

2.  The clinical implications of adopting new criteria for the grading of internal carotid artery stenosis.

Authors:  Nicole Curtis; Martin Necas; Matthew Versteeg
Journal:  Australas J Ultrasound Med       Date:  2018-02-14

3.  Extracting a stroke phenotype risk factor from Veteran Health Administration clinical reports: an information content analysis.

Authors:  Danielle L Mowery; Brian E Chapman; Mike Conway; Brett R South; Erin Madden; Salomeh Keyhani; Wendy W Chapman
Journal:  J Biomed Semantics       Date:  2016-05-10
  3 in total

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