Abstract:
Pediatric heart disease is a large and diverse field with an overall prevalence estimated at 6 to 13 per 1,000 live births. This document discusses appropriateness of advanced imaging for a broad range of variants. Diseases covered include tetralogy of Fallot, transposition of great arteries, congenital or acquired pediatric coronary artery abnormality, single ventricle, aortopathy, anomalous pulmonary venous return, aortopathy and aortic coarctation, with indications for advanced imaging spanning the entire natural history of the disease in children and adults, including initial diagnosis, treatment planning, treatment monitoring, and early detection of complications. 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 process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
摘要:
小儿心脏病是一个庞大且多样化的领域,总体患病率估计为每1,000例活产6至13。本文件讨论了各种变体的高级成像的适当性。所涵盖的疾病包括法洛四联症,大动脉转位,先天性或获得性小儿冠状动脉异常,单心室,主动脉病,肺静脉回流异常,主动脉病和主动脉缩窄,有迹象表明,在儿童和成人的疾病的整个自然史先进的成像,包括初步诊断,治疗计划,治疗监测,早期发现并发症。美国放射学会适当性标准是针对特定临床状况的循证指南,每年由多学科专家小组审查。指南的制定和修订过程支持对同行评审期刊的医学文献进行系统分析。既定的方法论原则,如建议评估分级,发展,评估或等级适用于评估证据。RAND/UCLA适当性方法用户手册提供了确定特定临床场景的成像和治疗程序适当性的方法。在那些缺乏同行评审文献或模棱两可的情况下,专家可能是制定建议的主要证据来源。