Original ArticlesAppropriateness of Outpatient Echocardiograms Ordered by Pediatric Cardiologists or Other Clinicians
Section snippets
Methods
We reviewed medical records of patients aged <18 years who underwent initial outpatient TTE at our center during a 6-month period (April 1, 2014, to September 30, 2014) before publication of the pediatric AUC document. All patients seen by the pediatric cardiologists had a clinic encounter associated with the order and details of the clinical indication readily available. These patients were included in the previously published AUC implementation study.6 The noncardiology providers were either
Results
The 1921 initial outpatient TTE evaluations performed during the study period included 1625 (84.8%) ordered by cardiologists, 176 (9.2%) ordered by pediatricians, 66 (3.4%) ordered by FPs, and 54 (2.8%) ordered by noncardiology subspecialists. These orders were from 38 different cardiologists, 127 pediatricians, 51 FPs, and 18 noncardiology subspecialists. These subspecialists included otolaryngologists (n = 3), pediatric surgeons (n = 3), endocrinologists (n = 2), gastroenterologists (n = 2),
Discussion
This study reports the differences in appropriateness of TTEs ordered by pediatric cardiologists and noncardiologists based on the pediatric AUC. The ordering pattern of physicians in this study was not influenced by the AUC document, because the data were collected from a period before publication of the document. This study shows that at our center, PCPs and noncardiology subspecialists order fewer TTEs than cardiologists. The cardiologists had a significantly higher proportion of studies
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Cited by (0)
The authors declare no conflicts of interest.
Portions of this study were presented as an abstract during the Cardiology Section of the American Academy meeting, Washington, DC, October 24-27, 2015.