BACKGROUND: Appropriateness criteria were applied to outpatient transthoracic echocardiographic (TTE) studies. METHODS: Indications were rated as appropriate, inappropriate, or unclassifiable, considering provider-stated indications, previous TTE studies, symptom changes, and patient-stated indications. Clinically important new or unexpected findings were recorded. RESULTS: Of 368 TTE studies, 206 (56%) were appropriate, 31 (8%) were inappropriate, and 131 (35%) were unclassifiable. Appropriateness was not correlated with patient or provider demographics. In 288 cases with prior TTE studies, there were 92 (32%) important new findings and 63 (22%) unexpected findings, of which 20% were from inappropriately ordered and 31% from unclassifiable TTE studies. Appropriateness was not associated with new (odds ratio, 1.23; 95% confidence interval, 0.48-3.18) or unexpected (odds ratio, 1.15; 95% confidence interval, 0.38-3.52) findings. Provider type and level of training were not correlated with new or unexpected findings. CONCLUSIONS: Many indications for TTE studies were unclassifiable. A high percentage of inappropriately ordered TTE studies yielded important information. Care must be taken in judging the value of TTE studies solely on the basis of appropriateness criteria.
BACKGROUND: Appropriateness criteria were applied to outpatient transthoracic echocardiographic (TTE) studies. METHODS: Indications were rated as appropriate, inappropriate, or unclassifiable, considering provider-stated indications, previous TTE studies, symptom changes, and patient-stated indications. Clinically important new or unexpected findings were recorded. RESULTS: Of 368 TTE studies, 206 (56%) were appropriate, 31 (8%) were inappropriate, and 131 (35%) were unclassifiable. Appropriateness was not correlated with patient or provider demographics. In 288 cases with prior TTE studies, there were 92 (32%) important new findings and 63 (22%) unexpected findings, of which 20% were from inappropriately ordered and 31% from unclassifiable TTE studies. Appropriateness was not associated with new (odds ratio, 1.23; 95% confidence interval, 0.48-3.18) or unexpected (odds ratio, 1.15; 95% confidence interval, 0.38-3.52) findings. Provider type and level of training were not correlated with new or unexpected findings. CONCLUSIONS: Many indications for TTE studies were unclassifiable. A high percentage of inappropriately ordered TTE studies yielded important information. Care must be taken in judging the value of TTE studies solely on the basis of appropriateness criteria.
Authors: Melvin D Cheitlin; William F Armstrong; Gerard P Aurigemma; George A Beller; Fredrick Z Bierman; Jack L Davis; Pamela S Douglas; David P Faxon; Linda D Gillam; Thomas R Kimball; William G Kussmaul; Alan S Pearlman; John T Philbrick; Harry Rakowski; Daniel M Thys; Elliott M Antman; Sidney C Smith; Joseph S Alpert; Gabriel Gregoratos; Jeffrey L Anderson; Loren F Hiratzka; David P Faxon; Sharon Ann Hunt; Valentin Fuster; Alice K Jacobs; Raymond J Gibbons; Richard O Russell Journal: J Am Soc Echocardiogr Date: 2003-10 Impact factor: 5.251
Authors: M Senni; R J Rodeheffer; C M Tribouilloy; J M Evans; S J Jacobsen; K R Bailey; M M Redfield Journal: J Am Coll Cardiol Date: 1999-01 Impact factor: 24.094
Authors: Thomas P Koshy; Anand Rohatgi; Sandeep R Das; Angela L Price; Andres deLuna; Nicholas Reimold; Kyle Willett; Sharon C Reimold; Susan A Matulevicius Journal: Int J Cardiovasc Imaging Date: 2015-01-23 Impact factor: 2.357
Authors: Behnam Banihashemi; Kasra Maftoon; Benjamin J W Chow; Jordan Bernick; George A Wells; Ian G Burwash Journal: Cardiovasc Ultrasound Date: 2015-01-15 Impact factor: 2.062
Authors: Steven Promislow; Joseph G Abunassar; Behnam Banihashemi; Benjamin J Chow; Girish Dwivedi; Kasra Maftoon; Ian G Burwash Journal: Cardiovasc Ultrasound Date: 2016-08-15 Impact factor: 2.062