What does “direct or indirect” mean for Measure #11, as referenced in the preceding question? Is there an example of preferred language for the report?
The measure requires the radiologist to use a standardized method for stenosis quantification based on measurements of distal internal carotid diameter as the denominator. Direct measurements may be done using MR/CT; indirect methods will likely be used for duplex ultrasound studies. Having velocity parameters correlate to the residual internal carotid lumen, with methods based on the distal internal carotid lumen, is an equivalent validating method and can be stated as such in the report. The comparative measurements are not made as part of the carotid ultrasound. The diameter stenosis range reported based on the velocity measurements should correlate with angiographic measurements using a method such as NASCET (as opposed, for example, to representing an area stenosis or a diameter stenosis related to the carotid bulb). A short note can be made in the final report, such as: “Severe left ICA stenosis of 70-80% by NASCET criteria” or “Severe left ICA stenosis of 70-80% by criteria simi
