Abstract
Introduction
Accurate, safe, and cost-effective noninvasive vascular tests (NIVTs) upon which vascular specialists can confidently base recommendations for treatment decisions are critically important for optimal patient care. Vascular surgeons are referred patients from many sources. These patients often present with NIVTs performed at a variety of facilities. A vascular specialist must be aware of the accuracy of NIVTs from his vascular lab as well as those sent from other facilities in order to make correct treatment recommendations. Without this knowledge, the consultant must either repeat the NIVT in a vascular lab with known quality assurance (QA) statistics or order arteriograms or other tests.
Methods
In order to determine the accuracy of studies from other facilities, the Vascular Diagnostic Center of Oak Ridge (VDC) and the vascular surgeons that practice at the Methodist Medical Center of Oak Ridge (MMC) developed an ongoing quality assurance program to address the quality and accuracy of NIVTs from other facilities. Since 1985, duplex vascular studies from other vascular laboratories, hospitals, and physician offices have been carefully compared with NIVTs performed at the VDC. We also compared all studies from VDC and other facilities to arteriograms and to pathology demonstrated in the operating room at MMC in patients who underwent surgery.
Conclusions
In the QA experience of VDC, studies from Intersocietal Commission for the Accreditation of Vascular Laboratories (ICAVL)-accredited laboratories were accurate in 83% of reviewed cases, whereas studies from facilities without ICAVL accreditation generated much lower correlation to quality and accuracy indices. This information is clearly valuable to physicians, patients, and third-party payers.
Get full access to this article
View all access options for this article.