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The standard targets a pre-test and prevalence threshold of 60% CAD, with indicators focused on per-patient and per-vessel prevalence of CAD-RADS 4 and ≥70% ICA stenosis using a decision-matrix approach. Data are collected retrospectively from CRIS and referral letters, including demographics, risk factors, heart rate, exam dates, and vessel-specific CAD-RADS grading. Outcomes are reported as per-patient and per-vessel true positives, true negatives, false positives, and false negatives, with exclusions for specific timing and diagnostic limitations. Suggested cohort size is 50, with actions if targets are not met via risk stratification discussions and alternative testing decisions.",{"@graph":63,"@context":119},[64,80,102],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/audit-template-using-cad-rads-tm-computed-tomography-coronary-angiography-ctca-versus-the-gold-standard-of-invasive-coronary-angiography-ica/174796/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/audit-template-using-cad-rads-tm-computed-tomography-coronary-angiography-ctca-versus-the-gold-standard-of-invasive-coronary-angiography-ica/174796.png","ImageObject",442,249,{"name":88,"@type":89},"Bintang","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-10-26","2026-09-02",true,{"@type":98,"interactionType":99,"userInteractionCount":101},"InteractionCounter",{"@type":100},"ViewAction",10,{"@type":103,"mainEntity":104},"FAQPage",[105,111,115],{"name":106,"@type":107,"acceptedAnswer":108},"What is the audit standard and target used in the template?","Question",{"text":109,"@type":110},"The standard sets pre-test probability of CAD at 60%, and the target prevalence of CAD is also set at 60%.","Answer",{"name":112,"@type":107,"acceptedAnswer":113},"Which indicators are used to assess local practice quality?",{"text":114,"@type":110},"Indicators measure the prevalence of patients with CAD-RADS ≥4 and ≥70% stenosis on ICA, analyzed per patient and per vessel using a decision matrix comparing CTCA with the gold standard ICA.",{"name":116,"@type":107,"acceptedAnswer":117},"What data items must be collected for each patient and vessel?",{"text":118,"@type":110},"Collect baseline demographics, ischemic heart disease risk factors, heart rate, dates of CTCA and ICA, and CAD-RADS grading for the most severe stenosis across each major vessel for both CTCA and ICA.","https://schema.org",{"og:url":78,"og:type":121,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":123,"canonical":78},"index,follow",{"doc_id":125,"site_id":56},174796,1788316546,{"code":4,"msg":5,"data":128},{"doc_id":125,"user_id":129,"nickname":88,"user_avatar":130,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":131,"file_id":132,"file_url":133,"file_type":134,"file_size":135,"view_count":101,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":126,"read_time":9},962085564381,"https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Audit template using CAD-RADS TM - Computed tomography coronary angiography (CTCA) versus the gold standard of invasive coronary angiography (ICA).\nDescriptor:\nAn audit template using a recognised grading system for stenosis severity Coronary Artery Disease - Reporting and Data System (CAD-RADSTM)[1] for CTCA reports in comparison with invasive coronary angiogram stenosis for each patient to assess the prevalence of disease sufficient to indicate catheter angiography.\nBackground:\nCT coronary angiography is increasingly used for first line investigation of coronary artery disease (CAD) in patients with typical and atypical angina. With this increasing volume of work it is important to develop robust clinical audit tools to ensure quality. To date within the UK, there has been significant work ensuring the lowest appropriate radiation dose in CTCA, and national audit evaluating individual centre mean dose as a surrogate for quality [2]. We propose and evaluate an audit tool evaluating report quality. Previous guidelines (NICE CG95)[3] have suggested a pretest probability of greater than 60% incidence of disease is sufficient to indicate catheter angiography[4]. We propose this is an appropriate audit standard for those patients referred for ICA following CTCA. In our institution we use standardised reporting templates including a recognised grading system for stenosis severity (CAD-RADSTM). This has enabled us to perform a secondary audit analysis evaluating discrepancy between CTCA and ICA.\nThe Cycle\nThe standard:\nPre-test probability of CAD 60%.\nTarget:\nPrevalence of CAD 60%.\nAssess local practice\nIndicators:\nThe prevalence of patients with ≥ CAD-RADS 4 and a ≥ 70% stenosis of CAD in ICA in a per patient and per vessel analysis based on decision matrix of test CTCA and gold standard ICA.\nData items to be collected:\nA retrospective search on Clinical Radiology Information System (CRIS) for patients with CTCA and ICA\nUse CRIS and referral letters to find:\nBaseline demographics of study population (age, gender, height, weight, BMI)\nRisk factors for ischaemic heart disease (diabetes, smoking, family history of premature CAD, Agaston calcium score)\nHeart rate\nDate of CTCA and ICA performed\nCAD-RADS grading for the most severe stenosis for each vessel (right coronary artery, left main stem, left anterior descending artery and circumflex artery) for CTCA and ICA.\nReporter\nPer patient and per vessel status of CAD-RADS 4 (true positive, true negative, false positive, false negative)\nPatients with ICA before CTCA, assessment for grafts/ stents, non diagnostic images and greater than 6 months between CTCA and ICA were excluded.\nSuggested number:\n50\nSuggestions for change if target not met:\nRisk stratification discussed by the accepting radiologist and discussion with the clinicians on alternative tests when appropriate.\nResources:\nExcel spreadsheet to analyse data attached\nCAD-RADS grading system (see references)\n\u0013 HYPERLINK \"https://www.rcr.ac.uk/sites/default/files/audit_template/audit_template_spreadsheet_ctca_vs_ica_1.xlsx\" \u0014audit_template_spreadsheet_ctca_vs_ica.xlsx\u0015EXCEL - 12.81 KB\nReferences:\nCury, Ricardo C. et al. CAD-RADSTM Coronary Artery Disease – Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI). Endorsed by the American College of Cardiology. Journal of Cardiovascular Computed Tomography, Volume 10, Issue 4, 2016, 269-281.\nIsabel A. Castellano, Edward D. Nicol, Russell K. Bull, Carl A. Roobottom, Michelle C. Williams, Stephen P. Harden. A prospective national survey of coronary CT angiography radiation doses in the United Kingdom. Journal of Cardiovascular Computed Tomography, Volume 11, Issue 4, 2017, 268-273.\nNational Institute for Health and Care Excellence. CG95 Chest pain of recent onset. 2016. \u0013 HYPERLINK \"https://www.nice.org.uk/guidance/cg95/evi","cbCailC4oEP2gCXx","https://ap.wps.com/l/cbCailC4oEP2gCXx","docx",29258,"English","# The cycle\n## The standard and target\n## Indicators and data items to collect\n## Reporter and exclusions\n## Suggested number and resources","[{\"question\":\"What is the audit standard and target used in the template?\",\"answer\":\"The standard sets pre-test probability of CAD at 60%, and the target prevalence of CAD is also set at 60%.\"},{\"question\":\"Which indicators are used to assess local practice quality?\",\"answer\":\"Indicators measure the prevalence of patients with CAD-RADS ≥4 and ≥70% stenosis on ICA, analyzed per patient and per vessel using a decision matrix comparing CTCA with the gold standard ICA.\"},{\"question\":\"What data items must be collected for each patient and vessel?\",\"answer\":\"Collect baseline demographics, ischemic heart disease risk factors, heart rate, dates of CTCA and ICA, and CAD-RADS grading for the most severe stenosis across each major vessel for both CTCA and ICA.\"}]","Audit template using CAD-RADS TM - Computed tomography coronary angiography (CTCA) versus the gold standard of invasive coronary angiography (ICA) | DOCX"]