Background: The optimal use of intravascular diagnostic techniques in patients with coronary artery diseases who are being considered for stenting remains to be defined.
Purpose: Generate prioritized topics for future research on the use of intravascular diagnostic techniques, building on evidence gaps identified in a prior comparative effectiveness review (CER) and following an explicit stakeholder-driven nomination and prioritization process.
Methods: Building on evidence gaps identified in a previous CER on intravascular diagnostic techniques, a preliminary list of future research needs (FRN) was supplemented and refined through input from stakeholders. Stakeholders were asked to rate each proposed priority topic considering the following dimensions in prioritization: (1) importance, (2) desirability of research/avoidance of unnecessary duplication, (3) feasibility, and (4) potential impact. The three topics with the highest number of stakeholder endorsements were identified as the prioritized FRN topics.
Future research needs topics: Two topics (one on the use of intravascular physiologic measurements like fractional flow reserve in treatment decisionmaking before stenting and one on the impact of the use of intravascular imaging diagnostics on stenting) are based directly on evidence gaps identified in the CER. One topic on the added value of intravascular diagnostic techniques in patients for whom there is already a clear clinical and other noninvasive diagnostic indication suggesting the need for revascularization was raised by the stakeholders.
Conclusions: This report identifies three high priority future research needs with regards to intravascular diagnostic techniques, as determined by a stakeholder panel. Both data from pragmatic randomized controlled trials and properly adjusted observational studies could be used to fill the gaps and help address the important clinical questions.