Health Sciences Program Student Theses, Dissertations and Capstones

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Philosophy (PhD) in Health Science

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences – Health Science Department

First Advisor

Michelle Ramim

Date of original Performance / Presentation

January 2025

Publication Date / Copyright Date

1-1-2025

Abstract

Objective: The variety of radiopharmaceuticals for similar imaging indications is a sign that not all facilities use agents with the highest available diagnostic accuracy as supported by clinical literature. This dissertation presents the decision-making factors for radiopharmaceutical choice in nuclear medicine myocardial perfusion imaging. Methods: An electronic survey was validated through the Delphi method, using a panel of 30 subject matter experts. The validated survey was completed by 128 respondents, providing ratings for the frequency of use of F-18 flurpiridaz, N-13 ammonia, Rb-82 chloride, Tc-99m sestamibi, Tc-99m tetrofosmin, and Tl-201 thallous chloride for myocardial perfusion imaging. Respondents also provided a 1-to-7 rating of importance for the radiopharmaceutical choice decision-making factors of familiarity, trust, ease of reimbursement, adequate reimbursement value, cost, availability from a local radiopharmacy, imaging quality, and diagnostic accuracy. Results: Although the respondents gave the highest rating of importance to the decision-making factor of diagnostic accuracy (6.609 out of 7), facilities most frequently used Tc-99m sestamibi for imaging, which has a lower diagnostic accuracy in the clinical literature, which was also true for most facilities that could utilize positron emission tomography (PET) radiopharmaceuticals with higher accuracy. Some demographic groups had significant differences in ratings, but most respondents provided similar ratings for frequency of use and importance of factors. Conclusions: Respondents consider diagnostic accuracy the most important decision-making factor in theory. However, facilities do not seem to follow the rational choice model of using radiopharmaceuticals with the highest clinically proven accuracy. Other decision-making factors may also influence these choices. Keywords: radiopharmaceuticals, myocardial perfusion imaging, choice, decision-making

Disciplines

Medicine and Health Sciences

Keywords

decision-making; molecular imaging; myocardial perfusion imaging; nuclear medicine; radiopharmaceuticals; rational choice

Download
To access this thesis/dissertation you must have a valid nova.edu OR mynsu.nova.edu email address and create an account for NSUWorks.

Free My Thesis

If you are the author of this work and would like to grant permission to make it openly accessible to all, please click the Free My Thesis button.

  Contact Author

Share

 
COinS