Challenges in Implementing Optimal Echocardiographic Screening in Cardio-Oncology

James P. McDonald, James P. MacNamara, Vlad Zaha

Research output: Contribution to journalReview article

Abstract

Purpose of review: Echocardiography is the foundation of noninvasive screening in patients exposed to potentially cardiotoxic chemotherapeutic agents. Guidelines are becoming more consistent in regard to screening and recommend an integrative approach between cardiology and oncology providers as well as optimal non-invasive imaging modalities. Optimal screening with the latest technology will place a significant cost and administrative burden on echocardiographic laboratories and cardiology clinics. Recent findings: This review seeks to explore the latest studies regarding quality, cost, patient burden, and value related to implementing wide-spread screening for patients exposed to cardiotoxic chemotherapy. 3D and speckle tracking echocardiography are more reliable and can detect more subtle changes than traditional 2D volumes. Limited studies have revealed an uptake of optimal screening between 30 and 40%. Even fewer studies have evaluated the system-wide cost and value impact of screening in cardio-oncology or have evaluated patient-centered outcomes, such as cost and time burden. Finally, novel approaches, such as the use of point of care ultrasound with artificial intelligence guidance, may help alleviate these challenges. Summary: Screening patients at risk for cancer therapeutics-related cardiac dysfunction poses real-world challenges to our healthcare system. While modern echocardiographic techniques improve our ability to detect cardiac dysfunction, further research is needed to understand the challenges of wide-spread implementation.

Original languageEnglish (US)
Article number39
JournalCurrent Treatment Options in Cardiovascular Medicine
Volume21
Issue number8
DOIs
StatePublished - Aug 1 2019

Fingerprint

Costs and Cost Analysis
Cardiology
Echocardiography
Cardiotoxins
Point-of-Care Systems
Artificial Intelligence
Guidelines
Technology
Delivery of Health Care
Drug Therapy
Research
Neoplasms
Therapeutics

Keywords

  • Cancer
  • Cardiotoxicity
  • Chemotherapy
  • Echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Challenges in Implementing Optimal Echocardiographic Screening in Cardio-Oncology. / McDonald, James P.; MacNamara, James P.; Zaha, Vlad.

In: Current Treatment Options in Cardiovascular Medicine, Vol. 21, No. 8, 39, 01.08.2019.

Research output: Contribution to journalReview article

@article{2d9126254ecc40599b5fd51a4689c1c4,
title = "Challenges in Implementing Optimal Echocardiographic Screening in Cardio-Oncology",
abstract = "Purpose of review: Echocardiography is the foundation of noninvasive screening in patients exposed to potentially cardiotoxic chemotherapeutic agents. Guidelines are becoming more consistent in regard to screening and recommend an integrative approach between cardiology and oncology providers as well as optimal non-invasive imaging modalities. Optimal screening with the latest technology will place a significant cost and administrative burden on echocardiographic laboratories and cardiology clinics. Recent findings: This review seeks to explore the latest studies regarding quality, cost, patient burden, and value related to implementing wide-spread screening for patients exposed to cardiotoxic chemotherapy. 3D and speckle tracking echocardiography are more reliable and can detect more subtle changes than traditional 2D volumes. Limited studies have revealed an uptake of optimal screening between 30 and 40{\%}. Even fewer studies have evaluated the system-wide cost and value impact of screening in cardio-oncology or have evaluated patient-centered outcomes, such as cost and time burden. Finally, novel approaches, such as the use of point of care ultrasound with artificial intelligence guidance, may help alleviate these challenges. Summary: Screening patients at risk for cancer therapeutics-related cardiac dysfunction poses real-world challenges to our healthcare system. While modern echocardiographic techniques improve our ability to detect cardiac dysfunction, further research is needed to understand the challenges of wide-spread implementation.",
keywords = "Cancer, Cardiotoxicity, Chemotherapy, Echocardiography",
author = "McDonald, {James P.} and MacNamara, {James P.} and Vlad Zaha",
year = "2019",
month = "8",
day = "1",
doi = "10.1007/s11936-019-0740-5",
language = "English (US)",
volume = "21",
journal = "Current Treatment Options in Cardiovascular Medicine",
issn = "1092-8464",
publisher = "Current Science, Inc.",
number = "8",

}

TY - JOUR

T1 - Challenges in Implementing Optimal Echocardiographic Screening in Cardio-Oncology

AU - McDonald, James P.

AU - MacNamara, James P.

AU - Zaha, Vlad

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Purpose of review: Echocardiography is the foundation of noninvasive screening in patients exposed to potentially cardiotoxic chemotherapeutic agents. Guidelines are becoming more consistent in regard to screening and recommend an integrative approach between cardiology and oncology providers as well as optimal non-invasive imaging modalities. Optimal screening with the latest technology will place a significant cost and administrative burden on echocardiographic laboratories and cardiology clinics. Recent findings: This review seeks to explore the latest studies regarding quality, cost, patient burden, and value related to implementing wide-spread screening for patients exposed to cardiotoxic chemotherapy. 3D and speckle tracking echocardiography are more reliable and can detect more subtle changes than traditional 2D volumes. Limited studies have revealed an uptake of optimal screening between 30 and 40%. Even fewer studies have evaluated the system-wide cost and value impact of screening in cardio-oncology or have evaluated patient-centered outcomes, such as cost and time burden. Finally, novel approaches, such as the use of point of care ultrasound with artificial intelligence guidance, may help alleviate these challenges. Summary: Screening patients at risk for cancer therapeutics-related cardiac dysfunction poses real-world challenges to our healthcare system. While modern echocardiographic techniques improve our ability to detect cardiac dysfunction, further research is needed to understand the challenges of wide-spread implementation.

AB - Purpose of review: Echocardiography is the foundation of noninvasive screening in patients exposed to potentially cardiotoxic chemotherapeutic agents. Guidelines are becoming more consistent in regard to screening and recommend an integrative approach between cardiology and oncology providers as well as optimal non-invasive imaging modalities. Optimal screening with the latest technology will place a significant cost and administrative burden on echocardiographic laboratories and cardiology clinics. Recent findings: This review seeks to explore the latest studies regarding quality, cost, patient burden, and value related to implementing wide-spread screening for patients exposed to cardiotoxic chemotherapy. 3D and speckle tracking echocardiography are more reliable and can detect more subtle changes than traditional 2D volumes. Limited studies have revealed an uptake of optimal screening between 30 and 40%. Even fewer studies have evaluated the system-wide cost and value impact of screening in cardio-oncology or have evaluated patient-centered outcomes, such as cost and time burden. Finally, novel approaches, such as the use of point of care ultrasound with artificial intelligence guidance, may help alleviate these challenges. Summary: Screening patients at risk for cancer therapeutics-related cardiac dysfunction poses real-world challenges to our healthcare system. While modern echocardiographic techniques improve our ability to detect cardiac dysfunction, further research is needed to understand the challenges of wide-spread implementation.

KW - Cancer

KW - Cardiotoxicity

KW - Chemotherapy

KW - Echocardiography

UR - http://www.scopus.com/inward/record.url?scp=85068803518&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85068803518&partnerID=8YFLogxK

U2 - 10.1007/s11936-019-0740-5

DO - 10.1007/s11936-019-0740-5

M3 - Review article

C2 - 31290034

AN - SCOPUS:85068803518

VL - 21

JO - Current Treatment Options in Cardiovascular Medicine

JF - Current Treatment Options in Cardiovascular Medicine

SN - 1092-8464

IS - 8

M1 - 39

ER -