• Frequently Asked Questions

    Type Size

    Who conducts ACE angiographic and appropriate-use reviews?

    ACE reviewers are board-certified cardiologists who have performed thousands of interventional/invasive procedures, have led CQI efforts and are skilled at helping organizations identify opportunities for improvement and develop action plans.

    What is the difference between a visual assessment and QCA done by a core lab?

    Appropriate-use assessments of clinical decisions can be done via visual examinations.  QCA provides objective and reproducible measurements of coronary artery dimensions, which allows for appropriate-use assessments to be measured using a standardized method.  Either approach may be helpful in evaluating individual operators depending on the quality issues being addressed.

    How are angiographic images delivered to ACE for review?

    We use ImageShare, a secure, HIPAA-compliant online environment for sharing high-resolution clinical images.  ImageShare is currently used by five large medical centers and a network of over 100 medical facilities.  By using ImageShare, we eliminate the risk, time and expense associated with distributing images on CDs by mail or courier.

    What's the difference between the various types of ACE reviews?

    The key components of each review type are outlined below:

    Angiographic review without clinical correlation

    • Random selection of cases from one or more operators at a single facility
    • Visual angiographic review is conducted to screen for misdiagnosis or inappropriate treatment
    • Includes a confidential report of conclusions aggregated by operator
    • Core lab option includes comparison of core lab measurements with clinically-reported stenosis severity

    Appropriate Use Review

    • Similar to angiographic review, but includes episodic or ongoing clincial correlation with angiographic findings
    • Clinical data review included to determine adherence to appropriate use criteria
    • Selection of cases for detailed reviews will include those with adverse outcomes as well as a random selection complicated and uncomplicated cases
    • Core lab option includes comparison of core lab measurements with clinically-reported stenosis severity

    Clinical data review without angiographic review, optional remote cath lab director services

    Particularly useful for facilities without a peer-review process or conflict-of-interest issues.

    • Review of clinical data for appropriate use
    • Review of outcome data (NCDR or internal data)
    • Option for remote cath lab director services, including conferences to discuss clinical trends, updates latest data and quality-related issues

    Low-volume operator review

    Useful for facilities with operators who do not perform a high-volume of interventional/invasive procedures.

    • Custom case reviews designed to focus on safety and efficiency
    • Review includes clinical data and angiography
    • Selection of cases for detailed reviews includes all cases with major adverse outcomes (death, MI, stroke, significant bleeding) as well as a random selection of cases

    How much does an ACE review cost?

    We offer multiple peer-review options ranging from individual case reviews to comprehensive, long-term programs.  For more information about which ACE peer-review program is best for you, contact us at info@cvexcel.org, or call 202-657-6859.