Abstract 11136: Predictors of Inappropriate Stress Echocardiography Use
Introduction. Inappropriate testing with stress echocardiography (SE) has previously been reported in about 20% of subjects. However, educational programs for educating ordering physicians have met with limited success. We sought the predictors of inappropriate testing.
Methods. Clinical information entered prospectively into the electronic medical record was used in combination with AHA appropriate use criteria in 1844 consecutive SE studies. Individual data were gathered on the referring physician and clinical status.
Results. Over half of all inappropriate SE were ordered by 3 specialties - electrophysiology (20%), cardiothoracic surgery (12%) and general internal medicine (14%). Two inappropriate clinical indications represent >75% of all inappropriate studies - symptomatic low CAD risk pts (54%), and preoperative risk assessment in pts with minor or no clinical risk (24%).
Conclusion. The majority of inappropriate studies are ordered by one of three subspeciality groups and involve one of two clinical indications. These data identify specific groups and indications to be targeted for future improvements in the appropriate use of SE.
- © 2011 by American Heart Association, Inc.