- 1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:
Coronary artery disease and acute coronary syndromes are a leading cause of morbidity and mortality. Plaque rupture and thrombosis are commonly associated with myocardial infarction and unstable angina. Therefore the ability to identify a vulnerable plaque has major clincal implications. There are new technologies that claim to indentify these so called vulnerable plaques. One device recently approved by the FDA is LipiScan that uses infrared spectroscopy to indentify lipid rich plaques_plaques which in theory have a higher probabilty of subsequent rupture.
What are the imaging modalities proposed to identify high risk plaques (i.g infrared spectroscopy)? What are the theoretical advantages and disadvantages of these devices? What are the harms associated with this technology? What are the instrumentation requirements?
- 2. Why do you think your question is important? (you may select more than one category if appropriate)
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My question relates to a very common disease or problem
People with this disease or problem have considerable health or financial hardships
There is uncertainty about how well the test, treatment, or intervention works
There is significant potential for side effects/harms using this test, treatment, or intervention
Funding of this test, treatment, or intervention is uncertain or variable
There is unequal access or application of this health care intervention across providers
There is potential for cost savings from better information on this subject
This is a new technology/development
There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention
Other
- 3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding)
- Coronary artery disease/artherosclerotic heart disease
- 4. What group(s) or patients does your question apply to?
- Individuals (adults >18 yo) with coronary artery disease (e.g. unstable angina) who are undergoing cardiac catheterization
- 5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply)
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Identification of a disease or condition:
Screening or diagnosis/identification for a particular disease, or risk assessment for a disease
Risks or harms that can come from a disease identification tool or test
Diagnostic tests and tools
Diagnosis of co-occurring diseases
Intervention (such as a drug treatment, therapy, device)
Management of a condition or particular system of care
Delivery of a health service
Referral
Risks or harms associated with treatment of a disease or condition
Prevention or health promotion
Specific population health concerns, such as ethnic group or gender
Other
Dont know
- 6. Does your question include a comparison of different health care approaches?
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No
If yes, please list what you would like to see compared:
Unsure that there will be information/data that directly compare near infrared spectroscopy & cardiac cath with more standard cardiac cath. But it would be informative to know what are the theoretical advantages and disadvantages and harms of this new technology.
- 7. Desired Health Improvements: If you question focuses on:
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Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?
Improved identification of so called vulnerable plaques (which theoretically are the culprit lesions for future myocardial infarction)
Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see? In patients with hx of MI or those individuals with unstable angina would like to see reduced rates of myocardial infarction and mortality. Shorter term outcomes; more aggressive risk factor management/ Again this is fairly new technology most likely there will not be evidence regarding these short and longer term outcomes
- 8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:
- There are risks associated with stenting. in theory using this type of device one would identify non occluding lesions with a lipid rich plaque and based on this information this lesion could be stented or there may be additional risk factor management (i.e. more aggressive lipid control, asa, increased freq of catherization or other non invasive testing)- all of which have their own inherent harms
- 9. Based on your answers to the previous questions, what research question(s) would you like to have answered?
- What are the imaging modalities proposed to identify high risk plaques (e.g infrared spectroscopy)? What are the theoretical advantages and disadvantages of these devices? What are the harms associated with this technology? What are the instrumentation requirements?
- 10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?
- American college of cardiology American heart association
- 11. Other Information About You (OPTIONAL) In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.
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a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
Other
b. Is there any other information about you that is relevant to your question?
N/A
c. Are you making a suggestion as an individual or on behalf of an organization?
Individual
Organization
