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Intravascular Diagnostic Procedures and Imaging Techniques Versus Angiography Alone in Coronary Stenting: Future Research Needs

Identification of Future Research Needs From Comparative Effectiveness Review No. 104

Future Research Needs Papers, No. 25

Investigators: , MD, MS, , MD, MS, , PhD, , MA, , PhD, , BS, and , PhD.

Author Information and Affiliations
Rockville (MD): Agency for Healthcare Research and Quality (US); .
Report No.: 13-EHC016-EF

Structured Abstract

Background:

The optimal use of intravascular diagnostic techniques in patients with coronary artery diseases who are being considered for stenting remains to be defined.

Purpose:

Generate prioritized topics for future research on the use of intravascular diagnostic techniques, building on evidence gaps identified in a prior comparative effectiveness review (CER) and following an explicit stakeholder-driven nomination and prioritization process.

Methods:

Building on evidence gaps identified in a previous CER on intravascular diagnostic techniques, a preliminary list of future research needs (FRN) was supplemented and refined through input from stakeholders. Stakeholders were asked to rate each proposed priority topic considering the following dimensions in prioritization: (1) importance, (2) desirability of research/avoidance of unnecessary duplication, (3) feasibility, and (4) potential impact. The three topics with the highest number of stakeholder endorsements were identified as the prioritized FRN topics.

Future research needs topics:

Two topics (one on the use of intravascular physiologic measurements like fractional flow reserve in treatment decisionmaking before stenting and one on the impact of the use of intravascular imaging diagnostics on stenting) are based directly on evidence gaps identified in the CER. One topic on the added value of intravascular diagnostic techniques in patients for whom there is already a clear clinical and other noninvasive diagnostic indication suggesting the need for revascularization was raised by the stakeholders.

Conclusions:

This report identifies three high priority future research needs with regards to intravascular diagnostic techniques, as determined by a stakeholder panel. Both data from pragmatic randomized controlled trials and properly adjusted observational studies could be used to fill the gaps and help address the important clinical questions.

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2007-10055-I. Prepared by: Tufts Evidence-based Practice Center, Boston, MA

Suggested citation:

Ip S, Raman G, Concannon T, Ratichek SJ, Yu W, Kong Win Chang L, Iovin R. Intravascular Diagnostic Procedures and Imaging Techniques Versus Angiography Alone in Coronary Artery Stenting: Future Research Needs. Future Research Needs Paper No. 25. (Prepared by Tufts Evidence-based Practice Center under Contract No. 290-2007-10055-I.) AHRQ Publication No. 13-EHC016-EF. Rockville, MD: Agency for Healthcare Research and Quality. February 2013. www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Tufts Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10055-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report.

1

540 Gaither Road, Rockville, MD 20850; www​.ahrq.gov

Bookshelf ID: NBK148748PMID: 23865094

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