Abstract
Transthoracic echocardiography (TTE) Appropriate Use Criteria (AUC) were developed to promote high-value care. We describe the prevalence of clinically significant abnormal TTE findings overall and in subgroups defined by appropriate and inappropriate AUC, and their association with clinical impact. 548 consecutive TTEs at an academic medical center were retrospectively reviewed for AUC, clinical impact, and TTE abnormalities. TTE reports within 1 year of the index TTE were reviewed to determine if abnormalities were new, unchanged, or resolved. Clinical impact was classified into no change, active change, or continuation of care. 91 % of TTEs were appropriate, 5 % were inappropriate, and 4 % were uncertain by AUC. 46 % of all TTEs and 57 % of first-time TTEs had no significant TTE abnormalities. Appropriate TTEs had a higher prevalence of ≥1 TTE abnormality than inappropriate TTEs (56 vs. 33 %, p = 0.029). Among repeat TTEs, 72 % had ≥1 TTE abnormality, however only 25 % had a new abnormality. The prevalence of a new abnormality was similar between inappropriate and appropriate repeat TTEs (25 vs. 26 %, p = 1.0). The prevalence of ≥1 abnormality was similar between TTEs that resulted in active change and no change in care (70 vs. 64 %, p = 0.06). Although most TTEs were appropriate as defined by AUC, the majority had no significant abnormalities. Although most TTEs were appropriate by AUC, >50 % of all TTEs and 25 % of repeat TTEs had no significant abnormalities. Appropriate TTEs had a higher prevalence of abnormalities, however the prevalence of abnormalities was similar between TTEs that resulted in active change versus no change in care.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 521-528 |
| Number of pages | 8 |
| Journal | International Journal of Cardiovascular Imaging |
| Volume | 31 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 21 2015 |
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Keywords
- Appropriate use criteria
- Clinical decision-making
- Echocardiography
- Health services
- Retrospective study
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
The association of abnormal findings on transthoracic echocardiography with 2011 Appropriate Use Criteria and clinical impact. / Koshy, Thomas P.; Rohatgi, Anand; Das, Sandeep R.; Price, Angela L.; deLuna, Andres; Reimold, Nicholas; Willett, Kyle; Reimold, Sharon C.; Matulevicius, Susan A.
In: International Journal of Cardiovascular Imaging, Vol. 31, No. 3, 21.03.2015, p. 521-528.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The association of abnormal findings on transthoracic echocardiography with 2011 Appropriate Use Criteria and clinical impact
AU - Koshy, Thomas P.
AU - Rohatgi, Anand
AU - Das, Sandeep R.
AU - Price, Angela L.
AU - deLuna, Andres
AU - Reimold, Nicholas
AU - Willett, Kyle
AU - Reimold, Sharon C.
AU - Matulevicius, Susan A.
PY - 2015/3/21
Y1 - 2015/3/21
N2 - Transthoracic echocardiography (TTE) Appropriate Use Criteria (AUC) were developed to promote high-value care. We describe the prevalence of clinically significant abnormal TTE findings overall and in subgroups defined by appropriate and inappropriate AUC, and their association with clinical impact. 548 consecutive TTEs at an academic medical center were retrospectively reviewed for AUC, clinical impact, and TTE abnormalities. TTE reports within 1 year of the index TTE were reviewed to determine if abnormalities were new, unchanged, or resolved. Clinical impact was classified into no change, active change, or continuation of care. 91 % of TTEs were appropriate, 5 % were inappropriate, and 4 % were uncertain by AUC. 46 % of all TTEs and 57 % of first-time TTEs had no significant TTE abnormalities. Appropriate TTEs had a higher prevalence of ≥1 TTE abnormality than inappropriate TTEs (56 vs. 33 %, p = 0.029). Among repeat TTEs, 72 % had ≥1 TTE abnormality, however only 25 % had a new abnormality. The prevalence of a new abnormality was similar between inappropriate and appropriate repeat TTEs (25 vs. 26 %, p = 1.0). The prevalence of ≥1 abnormality was similar between TTEs that resulted in active change and no change in care (70 vs. 64 %, p = 0.06). Although most TTEs were appropriate as defined by AUC, the majority had no significant abnormalities. Although most TTEs were appropriate by AUC, >50 % of all TTEs and 25 % of repeat TTEs had no significant abnormalities. Appropriate TTEs had a higher prevalence of abnormalities, however the prevalence of abnormalities was similar between TTEs that resulted in active change versus no change in care.
AB - Transthoracic echocardiography (TTE) Appropriate Use Criteria (AUC) were developed to promote high-value care. We describe the prevalence of clinically significant abnormal TTE findings overall and in subgroups defined by appropriate and inappropriate AUC, and their association with clinical impact. 548 consecutive TTEs at an academic medical center were retrospectively reviewed for AUC, clinical impact, and TTE abnormalities. TTE reports within 1 year of the index TTE were reviewed to determine if abnormalities were new, unchanged, or resolved. Clinical impact was classified into no change, active change, or continuation of care. 91 % of TTEs were appropriate, 5 % were inappropriate, and 4 % were uncertain by AUC. 46 % of all TTEs and 57 % of first-time TTEs had no significant TTE abnormalities. Appropriate TTEs had a higher prevalence of ≥1 TTE abnormality than inappropriate TTEs (56 vs. 33 %, p = 0.029). Among repeat TTEs, 72 % had ≥1 TTE abnormality, however only 25 % had a new abnormality. The prevalence of a new abnormality was similar between inappropriate and appropriate repeat TTEs (25 vs. 26 %, p = 1.0). The prevalence of ≥1 abnormality was similar between TTEs that resulted in active change and no change in care (70 vs. 64 %, p = 0.06). Although most TTEs were appropriate as defined by AUC, the majority had no significant abnormalities. Although most TTEs were appropriate by AUC, >50 % of all TTEs and 25 % of repeat TTEs had no significant abnormalities. Appropriate TTEs had a higher prevalence of abnormalities, however the prevalence of abnormalities was similar between TTEs that resulted in active change versus no change in care.
KW - Appropriate use criteria
KW - Clinical decision-making
KW - Echocardiography
KW - Health services
KW - Retrospective study
UR - http://www.scopus.com/inward/record.url?scp=84925447633&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84925447633&partnerID=8YFLogxK
U2 - 10.1007/s10554-014-0582-x
DO - 10.1007/s10554-014-0582-x
M3 - Article
VL - 31
SP - 521
EP - 528
JO - International Journal of Cardiovascular Imaging
JF - International Journal of Cardiovascular Imaging
SN - 1569-5794
IS - 3
ER -