One Minute, Shared Decision-Making Aid Reduces Unnecessary Hospitalization

Additional cardiac imaging often unnecessary

Last week, Mayo Clinic researchers showed that using a shared decision-making aid to involve more patients in care decisions can prevent both unnecessary hospitalization and more advanced cardiac tests for patients with low-risk chest pain.

The "Chest Pain Choice" shared decision-making aid is one of the latest evidence-based practices built on high-sensitivity troponin rule-out of acute coronary syndrome for ED patients reporting acute chest pain. After the one-hour test, an additional "one minute" discussion to educate patients about their risk and reach a shared decision can prevent further unnecessary and costly testing.

ACVP Blog has discussed decision-making for acute chest pain before, suggesting that the fact the cardiac biomarker test can safely and accurately rule-out acute coronary syndrome within one hour "challenges [the] need" for commonly-used noninvasive imaging prior to patient discharge.

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Are you “Choosing Wisely” with Cardiac Imaging?

Results are in from the Choosing Wisely initiative - a campaign designed to reduce the use of frequent tests deemed "low value" - like cardiac imaging.

A recently published study from JAMA Internal Medicine examining the frequency and trends of services from 2012 Choosing Wisely recommendations across 25 million Anthem health plan members found statistically significant reductions in cardiac imaging and other "low value" services.

Some context: many uses of cardiac imaging were deemed "low value" by the ACC in 2012.

The American College of Cardiology contributed to some of the earliest Choosing Wisely recommendations from 2012 - the recommendations that this study tracked. One of these recommendations has since been withdrawn due to new science, but the four that remain relate to cardiac imaging.

They are:

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