La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma

Translated title of the contribution: The evaluation of the appropriateness of prescription of non-invasive diagnostic tests in cardiology: The case of echocardiography

Fabio Lattanzi, Mirco Magnani, Lauro Cortigiani, Sara Mandorla, Alfredo Zuppiroli, Roberto Lorenzoni, R. Macrì, D. Bernardi, C. Volterrani, V. Mazzoni, G. Barletta, G. F. Gensini, F. Mazzuoli, F. Mori, F. Pieri, R. Vergassola, M. Nannini, G. Zambaldi, S. Cerisano, C. LandiniS. Severi, A. Genovesi Ebert, A. Digiorgio, C. Venturini, M. Raugi, U. Baldini, M. T. Savoia, M. Paoletti, L. Odoguardi, L. Zanetti, M. Lazzari, V. Bonatti, R. Giannini, W. Vergoni, A. Franchi, M. De Tommasi, A. Boem, P. Fontanive, G. Ferrante, G. Baggiani, U. Conti, E. Cabani, F. Del Citerna, A. Bartolozzi, L. Tonelli, P. Baldini, G. Tartarini, E. Orsini, B. Reishenofer, S. Giaconi, D. Levantesi, R. Dabizzi, A. M. Traini, D. Mondanelli, M. Magni, A. Pesola, D. Nevola, R. Poddighe, S. Galiotto, G. Saba, L. Rey, M. Provvidenza, N. Piccioni

Research output: Contribution to journalArticlepeer-review

Abstract

Background. We evaluated the appropriateness of indications to WP for ambulatory patients performed during 4 weeks in 21 laboratories in Tuscany and Umbria, Italy. Methods. We collected the following data: the appropriateness of the prescription (according to the guidelines of the Italian Federation of Cardiology), the prescribing physician (cardiologist vs non-cardiologist), the synthetic result (normal vs abnormal) and the clinical utility (useful vs useless) of each exam. Results. We evaluated 2848 prescriptions (patients: 1450 males, 1398 females; mean age 62 years, range 15-90 years). The indications to test were of class I (appropriate) in 43.6%, of class II (of doubtfully appropriateness) in 36.8% and of class III (inappropriate) in 19.6% of the cases. In 60.8% of the cases the exam was considered abnormal. In particular, an abnormal result was found in 83.8% of class I, in 56.6% of class II and in 17.8% of class III exams (p <0.05). The exam was considered useful in 51.1% of the cases. In particular, a useful result was found in 78.9% of class I, in 39% of class II and in 12.1% of class III exams (p <0.05). Cardiologists prescribed 856/2848 tests (30%). Their indications were of class I in 58.8%, of class II in 29.8% and of class III in 11.4% of the cases vs 37,39.9 and 23.1% of non-cardiologists' prescriptions (p <0.05). Abnormal findings were found in 74.3% of cardiologist- vs 55% of non-cardiologist-prescribed examinations (odds ratio 2.45, 95% confidence interval 2.04-2.92; p <0.05); similarly, clinically useful information could be derived from 63.1% of cardiologist- vs 46% of non -cardiologist-prescribed examinations (odds ratio 2.07, 95% confidence interval 1.75-2.45; p <0.05). Conclusions. In Tuscany and Umbria, Italy, about half of the prescriptions for mbra can be considered inappropriate; appropriately prescribed exams more often provide abnormal and useful results; cardiologist-prescribed exams are significantly more appropriate, abnormal and useful.

Translated title of the contributionThe evaluation of the appropriateness of prescription of non-invasive diagnostic tests in cardiology: The case of echocardiography
Original languageItalian
Pages (from-to)613-618
Number of pages6
JournalItalian Heart Journal Supplement
Volume3
Issue number6
Publication statusPublished - 2002

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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