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Low Rate of Change in Care With Transthoracic Echocardiography

Only 31.8 percent of TTEs result in active change in care; most TTEs considered appropriately used
TUESDAY, July 23 (HealthDay News) -- Although more than 90 percent of transthoracic echocardiograms (TTEs) are considered appropriately used, only about 30 percent result in active change in care, according to a study published online July 22 in JAMA Internal Medicine.
In an effort to describe the proportion of TTEs that affect clinical care, Susan A. Matulevicius, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues conducted a retrospective review of medical records from 535 consecutive TTEs performed at an academic medical center. The TTEs were classified by two cardiologists according to 2011 appropriate use criteria.
The authors found that 31.8 percent of the TTEs resulted in an active change in care, while 46.9 and 21.3 percent, respectively, resulted in continuation of current care or no change in care. According to the 2011 appropriate use criteria, the vast majority (91.8 percent) of TTEs were considered appropriate, while 4.3 and 3.9 percent, respectively, were inappropriate and uncertain. The proportion of TTEs that led to active change in care was not significantly different for appropriate and inappropriate TTEs (32.2 and 21.7 percent, respectively; P = 0.29).
"The low rate of active change in care (31.8 percent) among TTEs mostly classified as appropriate (91.8 percent) highlights the need for a better method to optimize TTE utilization to use limited health care resources efficiently while providing high-quality care," the authors write.
Full Text (http://archinte.jamanetwork.com/article.aspx?articleid=1718444 )Editorial 1 (http://archinte.jamanetwork.com/article.aspx?articleid=1718438 )Editorial 2 (http://archinte.jamanetwork.com/article.aspx?articleid=1718440 )
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