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Coronary angiography is used as a diagnostic procedure to identify patients with coronary artery disease who need to undergo revascularization. The quality of its indication is widely discussed at present. The Swiss Societies of Cardiology, of Internal Medicine and of Thoracic and Cardiovascular Surgery decided to set up a consensus conference to evaluate the indications for angiography. For this a modified RAND approach (Delphi method) was used. An expert panel rated 374 indications for coronary angiography twice for appropriateness (more benefits than risks for the patient), and once for necessity (procedure has to be offered or discussed with the patient). In the panel an agreement percentage of 54% was noted. In 40% we observed neither agreement nor disagreement and in 6% we found disagreement among the panelists. The necessity ratings showed similar results: 48% agreement, 46% indetermination and 6% disagreement. The average median rating for appropriateness on a 1-9 point scale (1 = extremely inappropriate, 9 = extremely appropriate or necessary) was 6.3 over all given single indications and 7.3 for necessity. The results of appropriateness and necessity ratings presented in this paper reflect the findings of a 15-member Swiss panel.
Percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG) are major coronary revascularization procedures to relieve angina, prevent myocardial infarction and improve long-term survival. The quality of their indication is widely discussed at present. The Swiss Societies of Cardiology, of Internal Medicine and of Thoracic and Cardiovascular Surgery decided to set up a consensus conference to evaluate the indications for coronary revascularization. For this a modified RAND approach (Delphi method) was used. An expert panel rated 992 indications for coronary revascularization twice for appropriateness (more benefits than risks for the patient), and once for necessity (procedure has to be offered or discussed with the patient). In the panel an agreement percentage of 65% was noted. In 35% we observed neither agreement nor disagreement, and there was almost no disagreement among the panelists. The results of the necessity ratings were 48% agreement, 49% indetermination and 3% disagreement. The average median rating for appropriateness on a 1-9 point scale (1 = extremely inappropriate, 9 = extremely appropriate or necessary) was 7.7 over all given single indications and 7.2 for necessity. The results of appropriateness and necessity ratings presented in this paper reflect the findings of a 15-member Swiss panel.
The "Deutsche Gesellschaft für Kardiologie--Herzund Kreislaufforschung" (German Cardiac Society) was founded as "Deutsche Gesellschaft für Kreislaufforschung" on June 6, 1927, in Bad Nauheim by B. Kisch, Cologne, and A. Weber, Bad Nauheim. They were actively supported by F.M. Groedel, Bad Nauheim, who later in 1950--together with B. Kisch, now both of New York--was co-founder of the American College of Cardiology (ACC). Thus, our Society is the oldest society of cardiology in Europe. The first meeting of the Society was held in Cologne in 1928, with H. E. Hering as president. From that year on there was an annual meeting of the Society until the last one during WWII in 1941 in Bad Nauheim. After WWII the first meeting of the Society was held again in Bad Nauheim in 1949. The Society met there annually until 1982. From 1983 onwards--the Society now called "Deutsche Gesellschaft für Herz- und Kreislaufforschung"--the (spring) meeting has taken place in Mannheim. In 1974 an additional annual autumn meeting was established, taking place at alternating locations. The emphasis of these autumn meetings is placed on continuous medical education on a high level, contrary to the spring meetings focussing on the scientific aspects. In 1950 the Society joined the International Society and Federation of Cardiology (ISFC)--now the World Heart Federation (WHF)--in Paris, and in 1952 the European Society of Cardiology (E.S.C.) in London. According to its statutes, in 1994 the Society changed its name to "Deutsche Gesellschaft für Kardiologie--Herz- und Kreislaufforschung". The Society, which brings together cardiologists, clinicians in universities, community hospitals and in private practice, and researchers working in the field of cardiology, cardiac surgeons and pediatric cardiologists, has more than 4900 members, including 10 honorary members, and 13 corresponding members. The Society has 4 committees, 9 project groups and 10 clusters with 29 working groups, and sponsors 13 prizes and awards as well as 14 national and international grants.
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