Journal of

Background: Intravascular imaging is a tool to detect coronary artery atherosclerosis which plays the major role in vessel stenosis degree determination and plaque pathology as a supplement of invasive angiography. This study aimed at comparing Intravascular imaging with invasive angiography.

Materials and Methods: For retrieving second type studies, PubMed, Cochrane Library and Centre for Review and Dissemination (CRD) were searched up to September 2013.  Searching was carried out by two persons using angiography and intravascular imaging keywords. Studies which compared intravascular ultrasound technology with invasive angiography were analyzed.

Results: Based on studies which reported the rate of target lesion revascularization (TLR) after one year of follow-up, there was a statistically significant difference between intravascular ultrasound and invasive angiography alone. It seems that TLR rate was lower with intravascular ultrasound (P = 0.02).In terms of cost effectiveness, approximately 54, 000 USD spend per each QALY using IVUS method.

Conclusion: Although, intravascular ultrasound could be able to detect coronary arteries damages and help out physician in selecting the most appropriate treatment, but due to the high cost of an intravascular ultrasound catheter, the invasive angiography is choice of physicians and patients in coronary intervention. 

Background: Despite the fact that only one-third of chest pains occur due to heart diseases, still physicians have tendency to admit most of these patients to reduce risk of negligence and its consequences.Clinical decision support systems (CDSS) enable physicians to distinguish better cardiac from non-cardiac chest pain. This study reviewed articles which focused on this issue.

Materials and Methods: Google scholar and PubMed database were targeted for search. Out of ninety primary matching articles based on the title, abstract and keywords, 28 full texts were relevant which were included in this study.

Results: Included articles were classified into two categories such as managing hospital resources and increasing the accuracy of diagnosis. Study results in the first categoryshowed decrease in both reception and referral time up to 30% and length of hospital stay up to 26% using CDSS. In the second category, the highest reported accuracy of diagnosis was 97% and the maximum sensitivity and specificity were 100% and 89.43% respectively. Even though, the results of a study revealed that the accuracy of decision support system in diagnosing cardiac chest pain was better than the compared cardiologists.

Conclusion: Considering the role of CDSS in managing hospital resources and improving accuracy of diagnosing cardiac chest pain, it is suggested that emergency wards and cardiac screening centers equipped by these systems.