Abstract
Background: Appropriateness criteria were applied to outpatient transthoracic echocardiographic (TTE) studies. Methods: Indications were rated as appropriate, inappropriate, or unclassifiable, considering provider-stated indications, previous TTE studies, symptom changes, and patient-stated indications. Clinically important new or unexpected findings were recorded. Results: Of 368 TTE studies, 206 (56%) were appropriate, 31 (8%) were inappropriate, and 131 (35%) were unclassifiable. Appropriateness was not correlated with patient or provider demographics. In 288 cases with prior TTE studies, there were 92 (32%) important new findings and 63 (22%) unexpected findings, of which 20% were from inappropriately ordered and 31% from unclassifiable TTE studies. Appropriateness was not associated with new (odds ratio, 1.23; 95% confidence interval, 0.48-3.18) or unexpected (odds ratio, 1.15; 95% confidence interval, 0.38-3.52) findings. Provider type and level of training were not correlated with new or unexpected findings. Conclusions: Many indications for TTE studies were unclassifiable. A high percentage of inappropriately ordered TTE studies yielded important information. Care must be taken in judging the value of TTE studies solely on the basis of appropriateness criteria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 53-59 |
| Number of pages | 7 |
| Journal | Journal of the American Society of Echocardiography |
| Volume | 22 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2009 |
| Externally published | Yes |
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Keywords
- Appropriateness
- Echocardiography
- Outpatient
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
- Cardiology and Cardiovascular Medicine
Cite this
Application of Appropriateness Criteria in Outpatient Transthoracic Echocardiography. / Kirkpatrick, James N.; Ky, Bonnie; Rahmouni, Hind; Chirinos, Julio A.; Farmer, Steven A.; Fields, Anjali V.; Ogbara, Jeffrey; Eberman, Karen M.; Ferrari, Victor A.; Silvestry, Frank E.; Keane, Martin G.; Opotowsky, Alexander R.; Sutton, Martin St John; Wiegers, Susan E.
In: Journal of the American Society of Echocardiography, Vol. 22, No. 1, 01.2009, p. 53-59.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Application of Appropriateness Criteria in Outpatient Transthoracic Echocardiography
AU - Kirkpatrick, James N.
AU - Ky, Bonnie
AU - Rahmouni, Hind
AU - Chirinos, Julio A.
AU - Farmer, Steven A.
AU - Fields, Anjali V.
AU - Ogbara, Jeffrey
AU - Eberman, Karen M.
AU - Ferrari, Victor A.
AU - Silvestry, Frank E.
AU - Keane, Martin G.
AU - Opotowsky, Alexander R.
AU - Sutton, Martin St John
AU - Wiegers, Susan E.
PY - 2009/1
Y1 - 2009/1
N2 - Background: Appropriateness criteria were applied to outpatient transthoracic echocardiographic (TTE) studies. Methods: Indications were rated as appropriate, inappropriate, or unclassifiable, considering provider-stated indications, previous TTE studies, symptom changes, and patient-stated indications. Clinically important new or unexpected findings were recorded. Results: Of 368 TTE studies, 206 (56%) were appropriate, 31 (8%) were inappropriate, and 131 (35%) were unclassifiable. Appropriateness was not correlated with patient or provider demographics. In 288 cases with prior TTE studies, there were 92 (32%) important new findings and 63 (22%) unexpected findings, of which 20% were from inappropriately ordered and 31% from unclassifiable TTE studies. Appropriateness was not associated with new (odds ratio, 1.23; 95% confidence interval, 0.48-3.18) or unexpected (odds ratio, 1.15; 95% confidence interval, 0.38-3.52) findings. Provider type and level of training were not correlated with new or unexpected findings. Conclusions: Many indications for TTE studies were unclassifiable. A high percentage of inappropriately ordered TTE studies yielded important information. Care must be taken in judging the value of TTE studies solely on the basis of appropriateness criteria.
AB - Background: Appropriateness criteria were applied to outpatient transthoracic echocardiographic (TTE) studies. Methods: Indications were rated as appropriate, inappropriate, or unclassifiable, considering provider-stated indications, previous TTE studies, symptom changes, and patient-stated indications. Clinically important new or unexpected findings were recorded. Results: Of 368 TTE studies, 206 (56%) were appropriate, 31 (8%) were inappropriate, and 131 (35%) were unclassifiable. Appropriateness was not correlated with patient or provider demographics. In 288 cases with prior TTE studies, there were 92 (32%) important new findings and 63 (22%) unexpected findings, of which 20% were from inappropriately ordered and 31% from unclassifiable TTE studies. Appropriateness was not associated with new (odds ratio, 1.23; 95% confidence interval, 0.48-3.18) or unexpected (odds ratio, 1.15; 95% confidence interval, 0.38-3.52) findings. Provider type and level of training were not correlated with new or unexpected findings. Conclusions: Many indications for TTE studies were unclassifiable. A high percentage of inappropriately ordered TTE studies yielded important information. Care must be taken in judging the value of TTE studies solely on the basis of appropriateness criteria.
KW - Appropriateness
KW - Echocardiography
KW - Outpatient
UR - http://www.scopus.com/inward/record.url?scp=58149091284&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58149091284&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2008.10.020
DO - 10.1016/j.echo.2008.10.020
M3 - Article
C2 - 19131002
AN - SCOPUS:58149091284
VL - 22
SP - 53
EP - 59
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
SN - 0894-7317
IS - 1
ER -