Document Detail


Prospective evaluation of the clinical application of the American College of Cardiology Foundation/American Society of Echocardiography Appropriateness Criteria for transthoracic echocardiography.
MedLine Citation:
PMID:  19356497     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We sought to prospectively evaluate the clinical application of the American College of Cardiology Foundation/American Society of Echocardiography Appropriateness Criteria (AC) for transthoracic echocardiography in a single-center university hospital. Indications for transthoracic echocardiograms (TTE) were prospectively determined for consecutive studies by 2 reviewers and categorized, according to the AC for TTE, as appropriate (A) or inappropriate (I). The overall level of agreement in characterizing appropriateness between reviewers was high (kappa = 0.83). Among the 1,553 studies for which a primary indication was determined, 89% were covered in the AC for TTE. Of these studies, 89% were A, and 11% were I. New important TTE abnormalities were more common on A compared with I studies (40% vs. 17%, p < 0.001), and noncardiac specialists more frequently ordered I studies (13% vs. 9%, p = 0.04). In conclusion, the AC for TTE encompasses the majority of clinical indications for TTE and appears to reasonably stratify TTE ordering. However, revisions will be needed to fully capture and stratify appropriate clinical practice.
Authors:
R Parker Ward; Ibrahim N Mansour; Nicole Lemieux; Nitin Gera; Rupa Mehta; Roberto M Lang
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular imaging     Volume:  1     ISSN:  1876-7591     ISO Abbreviation:  JACC Cardiovasc Imaging     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2009-04-09     Completed Date:  2009-04-23     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  101467978     Medline TA:  JACC Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  663-71     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Chicago, Chicago, Illinois 60637, USA. pward@medicine.bsd.uchicago.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Echocardiography / standards,  utilization
Feasibility Studies
Female
Guideline Adherence*
Heart Diseases / ultrasonography*
Hospitals, University / standards
Humans
Illinois
Male
Middle Aged
Patient Selection*
Physician's Practice Patterns / standards
Practice Guidelines as Topic*
Prospective Studies
Quality of Health Care / standards*
Referral and Consultation / standards
Societies, Medical
Unnecessary Procedures
Utilization Review

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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