TY - JOUR
T1 - Outcomes issues regarding utilization of echocardiography in patients with known or suspected coronary artery disease.
AU - Kaul, S.
N1 - Funding Information:
Outcomes research is the buzzword around Washington and elsewhere these days. And because there is both Federal and other funding available fbr outcomes rescarch, almost everyone is jumping on the bandwagon. Overnight, a large array of experts has appeared on the scene. Unfortunately, outcomes re- From the Cardiovascular Division, University of Virginia School of Medicine, Charlottesville. Supported in part by grants from the National Institutes of Health (R01-HL48890), Bethesda, Maryland, and the American Heart Association, Dallas, Texas. Dr. KauI is an Established Investigator of the American Heart Association. Reprint requests: Sanjiv ICaul, MD, Cardiovascular Division, Box 188, Universityo f Virginia, Chark)ttesvillc,V A 22908. Copyright © 1996 by the American Society of Echocardiography. 0894-7317/96 $5.00 + 0 27/1/65475 search is a poorly defined entity and a large amount of data have emerged from retrospective dredging of large databases such as those maintained by Medicare and insurance companies. Although such data can be used for developing hypotheses, in my opinion, they cannot be used to test therapeutic and diagnostic strategies. Nevertheless, in addition to common sense, some well-defined principles can be used to determine the value of a test in relation to a given patient. Table 1 lists the issues that should determine the utilization of a test.
PY - 1996
Y1 - 1996
N2 - In this opinion paper, outcomes issues that should determine the utilization of echocardiography in patients with known or suspected coronary artery disease is discussed. The issues discussed are the level of training and competence in performing and interpreting echocardiographic studies, sensitivity and specificity of the test in various conditions, ability to deal with artifacts, the pretest probability of disease, incremental value of a test in context of what is already known about a patient, cost-benefit analysis, and whether risk stratification is justified when risk management is not possible. Concepts, rather than an exhaustive view of the literature, are discussed and areas that require further investigation are mentioned.
AB - In this opinion paper, outcomes issues that should determine the utilization of echocardiography in patients with known or suspected coronary artery disease is discussed. The issues discussed are the level of training and competence in performing and interpreting echocardiographic studies, sensitivity and specificity of the test in various conditions, ability to deal with artifacts, the pretest probability of disease, incremental value of a test in context of what is already known about a patient, cost-benefit analysis, and whether risk stratification is justified when risk management is not possible. Concepts, rather than an exhaustive view of the literature, are discussed and areas that require further investigation are mentioned.
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U2 - 10.1016/S0894-7317(96)90133-9
DO - 10.1016/S0894-7317(96)90133-9
M3 - Article
C2 - 8827645
AN - SCOPUS:0030183551
SN - 0894-7317
VL - 9
SP - 591
EP - 598
JO - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
IS - 4
ER -