7 Modalities
1
Exercise electrocardiogram (ECG)5
2
Stress radionuclide imaging (single-photon emission computed tomography [SPECT]; positron emission tomography [PET])5
Part of the Medicare AUC program3
SPECT images on left courtesy of Kim Allan Williams, MD.
PET images on right courtesy of W. A. Jaber, MD.
3
Stress echocardiography (echo)5
Image courtesy of H. C. Lewin, MD.
4
Stress cardiovascular magnetic resonance (CMR) imaging5
Part of the Medicare AUC program3
Images courtesy of D. H. Kwon, MD.
5
Coronary artery calcium (CAC) scoring5
Image courtesy of H. C. Lewin, MD.
6
Coronary computed tomography angiography (CCTA)5
Part of the Medicare AUC program3
Images courtesy of H. C. Lewin, MD.
7
Invasive coronary angiography5
Images courtesy of D. Wolinsky, MD.
Rating Appropriateness
The Multimodality AUC rate each imaging test by appropriateness for each indication based on technical capabilities, evidence, and clinical experience. When you use AUC, you'll get 1 of 3 ratings: appropriate, may be appropriate, or rarely appropriate.5
- Benefits generally outweigh risks
- Generally an effective option
- Dependent on physician judgment and patient-specific preferences
- Variable evidence regarding the risk-benefit ratio
- Potentially an effective option
- Dependent on clinical variables, physician judgment, and patient preferences
- Lack of evidence that benefits clearly outweigh risks
- Rarely an effective option
- Exceptions should have documentation of clinical reasons
For patients who may have more than 1 clinical indication, there is a flowchart that places indications into a hierarchy to help stratify test appropriateness.5
