TY - JOUR
T1 - Application of the Appropriateness Criteria for Echocardiography in an Academic Medical Center
AU - Aggarwal, Niti R.
AU - Wuthiwaropas, Punsak
AU - Karon, Barry L.
AU - Miller, Fletcher A.
AU - Pellikka, Patricia A.
N1 - Funding Information:
Dr Wuthiwaropas was supported by a grant from Bangkok Christian Hospital (Bangkok, Thailand).
PY - 2010/3
Y1 - 2010/3
N2 - Background: The authors examined the feasibility of application of the American College of Cardiology Foundation's appropriateness criteria for transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) at a large tertiary care practice. Methods: Indications for consecutive TTE and TEE were determined by chart review and classified according to the guidelines as appropriate, inappropriate, or uncertain or, for situations not addressed in the document, nonclassifiable. Results: Of the 529 studies reviewed, 469 were appropriate, 23 inappropriate, 1 uncertain, and 36 nonclassifiable. Inappropriate and nonclassifiable studies were more commonly TTE than TEE (P < .001). Inappropriate studies were more common in outpatients than inpatients (P < .001). Nonclassifiable cases included assessment after radiofrequency ablation (33.3%) and preoperative evaluation (8.3%). Disagreement between observers in selection of the criterion was present in 30.8%. Conclusions: Although the study was conducted retrospectively, only 4.7% of classifiable studies were inappropriate. The reproducibility of classification was moderate, and 6.8% of studies were not classifiable. Areas for improvement of the criteria were identified.
AB - Background: The authors examined the feasibility of application of the American College of Cardiology Foundation's appropriateness criteria for transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE) at a large tertiary care practice. Methods: Indications for consecutive TTE and TEE were determined by chart review and classified according to the guidelines as appropriate, inappropriate, or uncertain or, for situations not addressed in the document, nonclassifiable. Results: Of the 529 studies reviewed, 469 were appropriate, 23 inappropriate, 1 uncertain, and 36 nonclassifiable. Inappropriate and nonclassifiable studies were more commonly TTE than TEE (P < .001). Inappropriate studies were more common in outpatients than inpatients (P < .001). Nonclassifiable cases included assessment after radiofrequency ablation (33.3%) and preoperative evaluation (8.3%). Disagreement between observers in selection of the criterion was present in 30.8%. Conclusions: Although the study was conducted retrospectively, only 4.7% of classifiable studies were inappropriate. The reproducibility of classification was moderate, and 6.8% of studies were not classifiable. Areas for improvement of the criteria were identified.
KW - Appropriateness
KW - Echocardiography
KW - Imaging
KW - Transesophageal echocardiography
KW - Transthoracic echocardiography
UR - http://www.scopus.com/inward/record.url?scp=77649233812&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77649233812&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2009.11.005
DO - 10.1016/j.echo.2009.11.005
M3 - Article
C2 - 20080385
AN - SCOPUS:77649233812
SN - 0894-7317
VL - 23
SP - 267
EP - 274
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 3
ER -