Most Frequent Inappropriate Indications

IndicationInappropriate studies (%)% of total studies
Detection of CAD; asymptomatic, low CHD risk*44.56.4
Asymptomatic, postrevascularization; <2 y after PCI, symptoms before PCI23.83.4
Evaluation of chest pain, low probability; interpretable ECG and able to exercise16.12.3
Asymptomatic/stable symptoms, known CAD < 1 y after catheterization or abnormal prior SPECT findings3.90.6
Preoperative assessment; low-risk surgery3.70.5
  • * CHD risk was determined by Framingham Risk score.

  • Remaining 8% of inappropriate studies are contained among the remaining inappropriate indications.

  • CAD = coronary artery disease; CHD = coronary heart disease; PCI = percutaneous coronary intervention; ECG = electrocardiogram.

  • Reprinted with permission of (16).