Inpatient Echocardiography Use for Common Cardiovascular Conditions
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A recent analysis of the Nationwide Inpatient Sample (NIS) found that inpatient echocardiography was associated with improved survival but was used only infrequently in clinical situations where echocardiography is often indicated.1 One potential limitation of this study was highlighted by an internal validation which showed that rates of echocardiography use were much higher at the author’s hospital than reported in NIS. For example, among patients with myocardial infarction, validation rates were 75% versus 6.3% for the NIS. Given this discrepancy, we sought to determine the accuracy of claims data, such as the NIS, for quantifying echocardiography use. We hypothesized that the International Classification Disease-9 Clinical Modification (ICD-9 CM) code for echocardiography (88.72) would show poor sensitivity for echocardiography use, and that actual echocardiography use rates would be higher than reported in NIS.
We used the Premier Healthcare Informatics (Charlotte, NC) dataset that includes data on a geographically and structurally diverse group of hospitals from 2014 to assess inpatient echocardiography across 8 broad patient conditions for which echocardiography is commonly ordered. Unlike NIS, which reports only standard demographic data and ICD-9 procedure and …