- ACCF/AHA/HRS/SCAI clinical competence statement on physician knowledge to optimize patient safety and image quality in fluoroscopically guided invasive cardiovascular procedures. A report of the American College of Cardiology Foundation/American Heart Association/American College of Physicians Task Force on Clinical Competence and Training. Hirshfeld, J.W., Balter, S., Brinker, J.A., Kern, M.J., Klein, L.W., Lindsay, B.D., Tommaso, C.L., Tracy, C.M., Wagner, L.K., Creager, M.A., Elnicki, M., Hirshfeld, J.W., Lorell, B.H., Rodgers, G.P., Tracy, C.M., Weitz, H.H. J. Am. Coll. Cardiol. (2004)