Advanced Cardiovascular Imaging Consortium

This study is a collaborative quality assurance initiative organized by Blue Cross Blue
Shield of Michigan and Blue Cross Network (BCBSM/BCN) for initiation of insurance coverage
of coronary artery CT scanning (CCTA), a relatively new procedure that can provide
non-invasive coronary angiograms. While this procedure has promise in that it can rapidly
diagnose patients with unknown chest pain and reduce the cost of medical care, there is
substantial potential for abuse and excess cost and inappropriate care if not appropriately
used.

The Consortium's objectives are to educate participating sites of the clinical uses of CCTA
as well as other best-practice recommendations; to create a database (Registry) to develop
evidence of the best-practice utilization of CCTA; to provide a feedback mechanism to the
sites about the positive or negative evidence of best-practice utilization of CCTA; to
develop strategies to improve the utilization of CCTA; to monitor the CQI process of the
individual participating sites; to reduce cost and improve safety and efficiency in in the
care of patients with acute chest pain, indeterminate stress tests results, and to assess
coronary bypass graft patency.

Inclusion Criteria:

(Patient must meet one criteria)

- Patient has had a CCTA examination ordered by a referring physician at a
participating site.

- Patient is a self referral.

Exclusion Criteria:

Clinical contraindications to CCTA are present as determined by attending physician or
staff, including but not limited to:

- Pregnancy or potential pregnancy.

- Renal failure or dysfunction.

- Inability to receive beta blockers.

- Allergy to iodinated contrast without prior premedication.

- Unwillingness to participate.

- Inability to read or understand Patient Information Sheet.

- Age less than 18 years without parent or guardian's evaluation of Patient Information
Sheet. Underage and other vulnerable populations are included as the CQI process is
intended to detect and correct adverse consequences of CCTA, e.g., excessive
radiation, and protect such patients.