Educational intervention helps ensure appropriate ECHO use

(HealthDay)—An appropriate use criteria (AUC)-based educational intervention can improve the appropriate use of outpatient transthoracic echocardiography (TTE), according to a study published online Aug. 13 in the JACC Cardiovascular Imaging.

R. Sacha Bhatia, M.D., M.B.A., from Women's College Hospital in Toronto, and colleagues randomized physicians-in-training to an AUC-based educational intervention on outpatient TTE ordering or to a control group.

The researchers found that the proportion of cardiology physicians-in-training inappropriately ordering TTE was significantly lower in the intervention than in the control group (13 versus 34 percent; P < 0.001), while the proportion of appropriate TTE ordered by the intervention group was significantly higher (81 versus 58 percent; P < 0.001). A smaller number of TTEs were ordered by the internal medicine physicians-in-training, but there was a trend toward significant odds of ordering an appropriate TTE in the intervention versus the control group (odds ratio, 8.1; 95 percent confidence interval, 0.95 to 69; P = 0.055).

"Six clinical scenarios accounted for 75 percent of all inappropriate TTE, with the three most common inappropriate indications being routine surveillance (<1 year) of known cardiomyopathy without a change in clinical status, routine surveillance of known small pericardial effusion, and routine surveillance of ventricular function with known coronary artery disease and no change in clinical status," the authors write.