Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography

Anum Minhas; Marc Dewey; Andrea L. Vavere; Yutaka Tanami; Mohammad R. Ostovaneh; Michael Laule; Carlos E. Rochitte; Hiroyuki Niinuma; Klaus F. Kofoed; Jacob Geleijns; John Hoe; Marcus Y. Chen; Kakuya Kitagawa; Cesar Nomura; Melvin E. Clouse; Frank J. Rybicki; Swee Yaw Tan; Narinder Paul; Matthew Matheson; Christopher Cox; Matthias Rief; Pia Maier; Sarah Feger; Michail Plotkin; Eva Schönenberger

doi:10.1148/radiol.2019181409

Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography

Anum Minhas
, Marc Dewey^*
, Andrea L. Vavere
, Yutaka Tanami
, Mohammad R. Ostovaneh
, Michael Laule
, Carlos E. Rochitte
, Hiroyuki Niinuma
, Klaus F. Kofoed
, Jacob Geleijns
, John Hoe
, Marcus Y. Chen
, Kakuya Kitagawa
, Cesar Nomura
, Melvin E. Clouse
, Frank J. Rybicki
, Swee Yaw Tan
, Narinder Paul
, Matthew Matheson
, Christopher Cox

Matthias Rief, Pia Maier, Sarah Feger, Michail Plotkin, Eva Schönenberger

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Abstract

Background: Patient preference is pivotal for widespread adoption of tests in clinical practice. Patient preferences for invasive versus other noninvasive tests for coronary artery disease are not known. Purpose: To compare patient acceptance and preferences for noninvasive and invasive cardiac imaging in North and South America, Asia, and Europe. Materials and Methods: This was a prospective 16-center trial in 381 study participants undergoing coronary CT angiography with stress perfusion, SPECT, and invasive coronary angiography (ICA). Patient preferences were collected by using a previously validated questionnaire translated into eight languages. Responses were converted to ordinal scales and were modeled with generalized linear mixed models. Results: In patients in whom at least one test was associated with pain, CT and SPECT showed reduced median pain levels, reported on 0-100 visual analog scales, from 20 for ICA (interquartile range [IQR], 4-50) to 6 for CT (IQR, 0-27.5) and 5 for SPECT (IQR, 0-25) (P , .001). Patients from Asia reported significantly more pain than patients from other continents for ICA (median, 25; IQR, 10-50; P = .01), CT (median, 10; IQR, 0-30; P = .02), and SPECT (median, 7; IQR, 0-28; P = .03). Satisfaction with preparation differed by continent and test (P = .01), with patients from Asia reporting generally lower ratings. Patients from North America had greater percentages of "very high" or "high" satisfaction than patients from other continents for ICA (96% vs 82%, respectively; P , .001) and SPECT (95% vs 79%, respectively; P = .04) but not for CT (89% vs 86%, respectively; P = .70). Among all patients, CT was preferred by 54% of patients, compared with 18% for SPECT and 28% for ICA (P , .001). Conclusion: For cardiac imaging, patients generally favored CT angiography with stress perfusion, while study participants from Asia generally reported lowest satisfaction.

Originalsprog	Engelsk
Tidsskrift	Radiology
Vol/bind	291
Udgave nummer	2
Sider (fra-til)	340-348
ISSN	0033-8419
DOI	https://doi.org/10.1148/radiol.2019181409
Status	Udgivet - maj 2019

Finansiering

Supported by Deutsche Forschungsgemeinschaft (DE 1361/14-1) and Canon Medical Systems (formerly operating as Toshiba Medical Systems). The study’s sponsor, Canon Medical Systems (formerly operating as Toshiba Medical Systems), was not involved in any stage of the study design, data acquisition, data analysis, or manuscript preparation. The study’s investigators had full control of the data. In addition, this research was supported in part by the Heisenberg Program of the German Research Foundation. Disclosures of Conflicts of Interest: A.M. disclosed no relevant relationships. M.D. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is a consultant for Guerbet; is a consultant to the editor of Radiology and is an associate editor of European Radiology; has received grants from the Heisenberg Program of the German Research Foundation for a Professorship (DE 1361/14-1), the European Regional Development Fund, joint program from the German Science Foundation and the German Federal Ministry of Education and Research for meta-analyses, the German Heart Foundation/German Foundation of Heart Research, GE Healthcare (Amersham), Bracco, Guerbet, and Toshiba Medical Systems; has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin, and Bayer; has received payment for manuscript preparation from the Lancet; holds a joint patent with Florian Michallek on dynamic perfusion analysis using fractal analysis (PCT/EP2016/071551); is the editor of Coronary CT Angiography and Cardiac CT, both published by Springer; has institutional master research agreements with Siemens Medical Solutions, Philips Medical Systems, and Toshiba Medical Systems (the terms of these arrangements are managed by the legal department of Charité–Universitätsmedizin Berlin). Other relationships: disclosed no relevant relationships. A.L.V. disclosed no relevant relationships. Y.T. disclosed no relevant relationships. M.R.O. disclosed no relevant relationships. M.L. disclosed no relevant relationships. C.E.R. disclosed no relevant relationships. H.N. disclosed no relevant relationships. K.F.K. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: institution has grants or grants pending from AP Møller og hustru Chastine McK-inney Møllers Fond, the John and Birthe Meyer Foundation, the Research Council of Rigshopitalet, the University of Copenhagen, the Danish Heart Foundation, the Lundbeck Foundation, and the Danish Agency for Science, Technology and Innovation by the Danish Council for Strategic Research; is on the speakers bureau of Canon Medical Systems. Other relationships: disclosed no relevant relationships. J.G. disclosed no relevant relationships. J.H. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is on the speakers bureau of Toshiba Medical Systems Asia. Other relationships: disclosed no relevant relationships. M.Y.C. disclosed no relevant relationships. K.K. disclosed no relevant relationships. C.N. disclosed no relevant relationships. M.E.C. disclosed no relevant relationships. F.J.R. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: is the medical director of Imagia Cybernetics. Other relationships: disclosed no relevant relationships. S.Y.T. disclosed no relevant relationships. N.P. disclosed no relevant relationships. M.M. disclosed no relevant relationships. C.C. disclosed no relevant relationships. M.R. disclosed no relevant relationships. P.M. disclosed no relevant relationships. S.F. disclosed no relevant relationships. M.P. disclosed no relevant relationships. E.S. disclosed no relevant relationships.

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Citationsformater

Minhas, A., Dewey, M., Vavere, A. L., Tanami, Y., Ostovaneh, M. R., Laule, M., Rochitte, C. E., Niinuma, H., Kofoed, K. F., Geleijns, J., Hoe, J., Chen, M. Y., Kitagawa, K., Nomura, C., Clouse, M. E., Rybicki, F. J., Tan, S. Y., Paul, N., Matheson, M., ... Schönenberger, E. (2019). Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography. Radiology, 291(2), 340-348. https://doi.org/10.1148/radiol.2019181409

Minhas, A, Dewey, M, Vavere, AL, Tanami, Y, Ostovaneh, MR, Laule, M, Rochitte, CE, Niinuma, H, Kofoed, KF, Geleijns, J, Hoe, J, Chen, MY, Kitagawa, K, Nomura, C, Clouse, ME, Rybicki, FJ, Tan, SY, Paul, N, Matheson, M, Cox, C, Rief, M, Maier, P, Feger, S, Plotkin, M & Schönenberger, E 2019, 'Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography', Radiology, bind 291, nr. 2, s. 340-348. https://doi.org/10.1148/radiol.2019181409

@article{6640116cb6774b69a6138f3878dc6f84,

title = "Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography",

abstract = "Background: Patient preference is pivotal for widespread adoption of tests in clinical practice. Patient preferences for invasive versus other noninvasive tests for coronary artery disease are not known. Purpose: To compare patient acceptance and preferences for noninvasive and invasive cardiac imaging in North and South America, Asia, and Europe. Materials and Methods: This was a prospective 16-center trial in 381 study participants undergoing coronary CT angiography with stress perfusion, SPECT, and invasive coronary angiography (ICA). Patient preferences were collected by using a previously validated questionnaire translated into eight languages. Responses were converted to ordinal scales and were modeled with generalized linear mixed models. Results: In patients in whom at least one test was associated with pain, CT and SPECT showed reduced median pain levels, reported on 0-100 visual analog scales, from 20 for ICA (interquartile range [IQR], 4-50) to 6 for CT (IQR, 0-27.5) and 5 for SPECT (IQR, 0-25) (P , .001). Patients from Asia reported significantly more pain than patients from other continents for ICA (median, 25; IQR, 10-50; P = .01), CT (median, 10; IQR, 0-30; P = .02), and SPECT (median, 7; IQR, 0-28; P = .03). Satisfaction with preparation differed by continent and test (P = .01), with patients from Asia reporting generally lower ratings. Patients from North America had greater percentages of {"}very high{"} or {"}high{"} satisfaction than patients from other continents for ICA (96\% vs 82\%, respectively; P , .001) and SPECT (95\% vs 79\%, respectively; P = .04) but not for CT (89\% vs 86\%, respectively; P = .70). Among all patients, CT was preferred by 54\% of patients, compared with 18\% for SPECT and 28\% for ICA (P , .001). Conclusion: For cardiac imaging, patients generally favored CT angiography with stress perfusion, while study participants from Asia generally reported lowest satisfaction.",

author = "Anum Minhas and Marc Dewey and Vavere, \{Andrea L.\} and Yutaka Tanami and Ostovaneh, \{Mohammad R.\} and Michael Laule and Rochitte, \{Carlos E.\} and Hiroyuki Niinuma and Kofoed, \{Klaus F.\} and Jacob Geleijns and John Hoe and Chen, \{Marcus Y.\} and Kakuya Kitagawa and Cesar Nomura and Clouse, \{Melvin E.\} and Rybicki, \{Frank J.\} and Tan, \{Swee Yaw\} and Narinder Paul and Matthew Matheson and Christopher Cox and Matthias Rief and Pia Maier and Sarah Feger and Michail Plotkin and Eva Sch{\"o}nenberger",

year = "2019",

month = may,

doi = "10.1148/radiol.2019181409",

language = "English",

volume = "291",

pages = "340--348",

journal = "Radiology",

issn = "0033-8419",

publisher = "Radiological Society of North America Inc.",

number = "2",

}

TY - JOUR

T1 - Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography

AU - Minhas, Anum

AU - Dewey, Marc

AU - Vavere, Andrea L.

AU - Tanami, Yutaka

AU - Ostovaneh, Mohammad R.

AU - Laule, Michael

AU - Rochitte, Carlos E.

AU - Niinuma, Hiroyuki

AU - Kofoed, Klaus F.

AU - Geleijns, Jacob

AU - Hoe, John

AU - Chen, Marcus Y.

AU - Kitagawa, Kakuya

AU - Nomura, Cesar

AU - Clouse, Melvin E.

AU - Rybicki, Frank J.

AU - Tan, Swee Yaw

AU - Paul, Narinder

AU - Matheson, Matthew

AU - Cox, Christopher

AU - Rief, Matthias

AU - Maier, Pia

AU - Feger, Sarah

AU - Plotkin, Michail

AU - Schönenberger, Eva

PY - 2019/5

Y1 - 2019/5

N2 - Background: Patient preference is pivotal for widespread adoption of tests in clinical practice. Patient preferences for invasive versus other noninvasive tests for coronary artery disease are not known. Purpose: To compare patient acceptance and preferences for noninvasive and invasive cardiac imaging in North and South America, Asia, and Europe. Materials and Methods: This was a prospective 16-center trial in 381 study participants undergoing coronary CT angiography with stress perfusion, SPECT, and invasive coronary angiography (ICA). Patient preferences were collected by using a previously validated questionnaire translated into eight languages. Responses were converted to ordinal scales and were modeled with generalized linear mixed models. Results: In patients in whom at least one test was associated with pain, CT and SPECT showed reduced median pain levels, reported on 0-100 visual analog scales, from 20 for ICA (interquartile range [IQR], 4-50) to 6 for CT (IQR, 0-27.5) and 5 for SPECT (IQR, 0-25) (P , .001). Patients from Asia reported significantly more pain than patients from other continents for ICA (median, 25; IQR, 10-50; P = .01), CT (median, 10; IQR, 0-30; P = .02), and SPECT (median, 7; IQR, 0-28; P = .03). Satisfaction with preparation differed by continent and test (P = .01), with patients from Asia reporting generally lower ratings. Patients from North America had greater percentages of "very high" or "high" satisfaction than patients from other continents for ICA (96% vs 82%, respectively; P , .001) and SPECT (95% vs 79%, respectively; P = .04) but not for CT (89% vs 86%, respectively; P = .70). Among all patients, CT was preferred by 54% of patients, compared with 18% for SPECT and 28% for ICA (P , .001). Conclusion: For cardiac imaging, patients generally favored CT angiography with stress perfusion, while study participants from Asia generally reported lowest satisfaction.

AB - Background: Patient preference is pivotal for widespread adoption of tests in clinical practice. Patient preferences for invasive versus other noninvasive tests for coronary artery disease are not known. Purpose: To compare patient acceptance and preferences for noninvasive and invasive cardiac imaging in North and South America, Asia, and Europe. Materials and Methods: This was a prospective 16-center trial in 381 study participants undergoing coronary CT angiography with stress perfusion, SPECT, and invasive coronary angiography (ICA). Patient preferences were collected by using a previously validated questionnaire translated into eight languages. Responses were converted to ordinal scales and were modeled with generalized linear mixed models. Results: In patients in whom at least one test was associated with pain, CT and SPECT showed reduced median pain levels, reported on 0-100 visual analog scales, from 20 for ICA (interquartile range [IQR], 4-50) to 6 for CT (IQR, 0-27.5) and 5 for SPECT (IQR, 0-25) (P , .001). Patients from Asia reported significantly more pain than patients from other continents for ICA (median, 25; IQR, 10-50; P = .01), CT (median, 10; IQR, 0-30; P = .02), and SPECT (median, 7; IQR, 0-28; P = .03). Satisfaction with preparation differed by continent and test (P = .01), with patients from Asia reporting generally lower ratings. Patients from North America had greater percentages of "very high" or "high" satisfaction than patients from other continents for ICA (96% vs 82%, respectively; P , .001) and SPECT (95% vs 79%, respectively; P = .04) but not for CT (89% vs 86%, respectively; P = .70). Among all patients, CT was preferred by 54% of patients, compared with 18% for SPECT and 28% for ICA (P , .001). Conclusion: For cardiac imaging, patients generally favored CT angiography with stress perfusion, while study participants from Asia generally reported lowest satisfaction.

U2 - 10.1148/radiol.2019181409

DO - 10.1148/radiol.2019181409

M3 - Journal article

C2 - 30888934

AN - SCOPUS:85065051554

SN - 0033-8419

VL - 291

SP - 340

EP - 348

JO - Radiology

JF - Radiology

IS - 2

ER -