The use of nuclear myocardial perfusion imaging (MPI) declined substantially in a large integrated healthcare system during a recent 5 years period. Following an increase in use from 2000 to 2006 at Kaiser Permanente Northern California, MPI use dropped by a relative 51% through 2011 according to Edward McNulty, MD, of Kaiser Permanente Medical Center in San Francisco. Replacement by cardiac CT and stress echocardiography did not explain the pullback from using MPI, the researchers reported March 26 issue of JAMA.
The fact that we observed greater declines amongst lower–risk subsets (outpatients and younger persons) suggests MPI use became more discriminating (used preferentially in higher–risk persons), as per the authors. Other reasons may be "more recently, factors potentially discouraging use, such as appropriate use criteria, declining reimbursement, radiology benefits managers,…
