| Comparison of the clinical application of the American College of Cardiology Foundation/American Society of Echocardiography Appropriateness Criteria for outpatient transthoracic echocardiography in academic and community practice settings. | |
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MedLine Citation:
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PMID: 19766446 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We sought to compare the clinical application of the American College of Cardiology Foundation/American Society of Echocardiography Appropriateness Criteria (AC) for outpatient transthoracic echocardiography (TTE) in academic and community practice settings. METHODS: Indications for TTE ordered in both academic and community practice settings were determined by 2 reviewers and categorized according to the AC for TTE as Appropriate, Inappropriate, or Not Addressed. Patient characteristics, ordering physician specialty, and TTE findings were also recorded. RESULTS: Overall, 814 academic and 319 community TTEs were analyzed. Interobserver variability for indication determination was high and did not differ between studies ordered at the 2 practice settings. Compared with the academic practice, community practice TTE indications were more likely to be classified in the AC for TTE (88% vs 82%, P = .04), but were ordered for a similar frequency of Appropriate (71% vs 68%, P = not significant) and Inappropriate (17% vs 15%, P = not significant) indications. New important TTE abnormalities were more frequently found in Appropriate studies compared with Inappropriate studies in both academic (35% vs 16%, P < .001) and community practice (29% vs 15%, P = .04) settings. CONCLUSION: The clinical application of the AC for TTE is feasible, and the frequency of Appropriate and Inappropriate outpatient TTEs is similar in academic and community practice settings. However, limitations of the AC for TTE are identified that suggest revisions will be needed to fully encompass and stratify the broad clinical practice of echocardiography. |
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Authors:
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R Parker Ward; Daniel Krauss; Ibrahim N Mansour; Nicole Lemieux; Nitin Gera; Roberto M Lang; ; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't Date: 2009-09-18 |
Journal Detail:
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Title: Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography Volume: 22 ISSN: 1097-6795 ISO Abbreviation: J Am Soc Echocardiogr Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-11-30 Completed Date: 2010-02-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8801388 Medline TA: J Am Soc Echocardiogr Country: United States |
Other Details:
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Languages: eng Pagination: 1375-81 Citation Subset: IM |
Affiliation:
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Non-Invasive Imaging Laboratories, Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA. pward@medicine.bsd.uchicago.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Academic Medical Centers
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standards,
utilization* Ambulatory Care / standards*, utilization* Chicago Community Health Centers / standards, utilization* Echocardiography / standards*, utilization* Guideline Adherence / statistics & numerical data* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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