Abstract:
BACKGROUND:Despite efforts targeting the growth of healthcare spending within the United States, the current increase in expenditures remains a widespread systemic issue. The overuse of healthcare testing has previously been identified as a modifiable contributing factor. One such test, echocardiography, has seen a continuous increase in its rate of use. This test is frequently ordered by primary-care physicians. HYPOTHESIS:In the setting of a low likelihood of disease, echocardiography does not substantially change cardiac therapy, even if appropriately ordered. METHODS:We randomly identified 500 patients who received an echocardiogram ordered by a primary-care physician between January 1, 2014, and December 31, 2014. Of these, 239 patient charts were reviewed and the following extracted: primary indication for the test, echocardiogram results, and changes in patient medical management. In addition, appropriateness of the test was assessed using the appropriate use criteria guidelines for echocardiography. RESULTS:Nearly 97% of the studies within the ambulatory primary-care setting were appropriately ordered according to the appropriate use criteria. Among the 239 patients studied, only 52 had abnormalities and only 6 (2.5%) experienced a change in management that corresponded with the initial suspected diagnosis and echocardiographic findings. CONCLUSIONS:To ensure the greatest value and optimize use of diagnostic testing, it may be necessary to develop a more comprehensive set of guidelines to assist clinicians to readily identify patient populations at low, moderate, and high risk for the presence of disease and provide educational interventions, including feedback regarding individual ordering behaviors.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Bethge A,Penciu O,Baksh S,Parve S,Lobraico J,Keller AMdoi
10.1002/clc.22810subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1212-1217issue
12eissn
0160-9289issn
1932-8737journal_volume
40pub_type
杂志文章,多中心研究abstract::Primum non nocere. Atrial fibrillation (AF) occurs commonly following coronary artery bypass graft surgery, although new onset atrial fibrillation in this setting is usually transient. When AF reverts or is converted to sinus rhythm it is unlikely to recur, whether or not the patient takes preventive medication. As no...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211004
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abstract::In addition to the role of the electrophysiological substrate, paroxysmal atrial fibrillation depends on the modulation of the atrial tissues by the autonomic nervous system. Experimentally, models of atrial fibrillation can be based on either adrenergic or vagal stimulations that provoke the arrhythmia by disturbing ...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130311
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journal_title:Clinical cardiology
pub_type: 杂志文章
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1993-06-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2009-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960061107
更新日期:1983-11-01 00:00:00
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:
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pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20254
更新日期:2008-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960170305
更新日期:1994-03-01 00:00:00
abstract::An unusual case of metastatic disease of the right ventricle is described in a 74-year-old woman who had presented with a malignant fibrous histiocytoma of the right thigh previously treated with surgery and radiotherapy. Two years later she presented with signs and symptoms of tricuspid regurgitation and right ventri...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960140216
更新日期:1991-02-01 00:00:00
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pub_type: 社论
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doi:10.1002/clc.20747
更新日期:2010-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/clc.4960190208
更新日期:1996-02-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1994-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/clc.4960170806
更新日期:1994-08-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1996-11-01 00:00:00