La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma

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. Landini; S. 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

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

Fondazione Don Carlo Gnocchi Onlus

Research output: Contribution to journal › Article › peer-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 contribution	The evaluation of the appropriateness of prescription of non-invasive diagnostic tests in cardiology: The case of echocardiography
Original language	Italian
Pages (from-to)	613-618
Number of pages	6
Journal	Italian Heart Journal Supplement
Volume	3
Issue number	6
Publication status	Published - 2002

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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Lattanzi, F., Magnani, M., Cortigiani, L., Mandorla, S., Zuppiroli, A., Lorenzoni, R., Macrì, R., Bernardi, D., Volterrani, C., Mazzoni, V., Barletta, G., Gensini, G. F., Mazzuoli, F., Mori, F., Pieri, F., Vergassola, R., Nannini, M., Zambaldi, G., Cerisano, S., ... Piccioni, N. (2002). La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma. Italian Heart Journal Supplement, 3(6), 613-618.

La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma. / Lattanzi, Fabio; Magnani, Mirco; Cortigiani, Lauro; Mandorla, Sara; Zuppiroli, Alfredo; Lorenzoni, Roberto; Macrì, R.; Bernardi, D.; Volterrani, C.; Mazzoni, V.; Barletta, G.; Gensini, G. F.; Mazzuoli, F.; Mori, F.; Pieri, F.; Vergassola, R.; Nannini, M.; Zambaldi, G.; Cerisano, S.; Landini, C.; Severi, S.; Genovesi Ebert, A.; Digiorgio, A.; Venturini, C.; Raugi, M.; Baldini, U.; Savoia, M. T.; Paoletti, M.; Odoguardi, L.; Zanetti, L.; Lazzari, M.; Bonatti, V.; Giannini, R.; Vergoni, W.; Franchi, A.; De Tommasi, M.; Boem, A.; Fontanive, P.; Ferrante, G.; Baggiani, G.; Conti, U.; Cabani, E.; Del Citerna, F.; Bartolozzi, A.; Tonelli, L.; Baldini, P.; Tartarini, G.; Orsini, E.; Reishenofer, B.; Giaconi, S.; Levantesi, D.; Dabizzi, R.; Traini, A. M.; Mondanelli, D.; Magni, M.; Pesola, A.; Nevola, D.; Poddighe, R.; Galiotto, S.; Saba, G.; Rey, L.; Provvidenza, M.; Piccioni, N.

In: Italian Heart Journal Supplement, Vol. 3, No. 6, 2002, p. 613-618.

Research output: Contribution to journal › Article › peer-review

Lattanzi, F, Magnani, M, Cortigiani, L, Mandorla, S, Zuppiroli, A, Lorenzoni, R, Macrì, R, Bernardi, D, Volterrani, C, Mazzoni, V, Barletta, G, Gensini, GF, Mazzuoli, F, Mori, F, Pieri, F, Vergassola, R, Nannini, M, Zambaldi, G, Cerisano, S, Landini, C, Severi, S, Genovesi Ebert, A, Digiorgio, A, Venturini, C, Raugi, M, Baldini, U, Savoia, MT, Paoletti, M, Odoguardi, L, Zanetti, L, Lazzari, M, Bonatti, V, Giannini, R, Vergoni, W, Franchi, A, De Tommasi, M, Boem, A, Fontanive, P, Ferrante, G, Baggiani, G, Conti, U, Cabani, E, Del Citerna, F, Bartolozzi, A, Tonelli, L, Baldini, P, Tartarini, G, Orsini, E, Reishenofer, B, Giaconi, S, Levantesi, D, Dabizzi, R, Traini, AM, Mondanelli, D, Magni, M, Pesola, A, Nevola, D, Poddighe, R, Galiotto, S, Saba, G, Rey, L, Provvidenza, M & Piccioni, N 2002, 'La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma', Italian Heart Journal Supplement, vol. 3, no. 6, pp. 613-618.

Lattanzi, Fabio ; Magnani, Mirco ; Cortigiani, Lauro ; Mandorla, Sara ; Zuppiroli, Alfredo ; Lorenzoni, Roberto ; Macrì, R. ; Bernardi, D. ; Volterrani, C. ; Mazzoni, V. ; Barletta, G. ; Gensini, G. F. ; Mazzuoli, F. ; Mori, F. ; Pieri, F. ; Vergassola, R. ; Nannini, M. ; Zambaldi, G. ; Cerisano, S. ; Landini, C. ; Severi, S. ; Genovesi Ebert, A. ; Digiorgio, A. ; Venturini, C. ; Raugi, M. ; Baldini, U. ; Savoia, M. T. ; Paoletti, M. ; Odoguardi, L. ; Zanetti, L. ; Lazzari, M. ; Bonatti, V. ; Giannini, R. ; Vergoni, W. ; Franchi, A. ; De Tommasi, M. ; Boem, A. ; Fontanive, P. ; Ferrante, G. ; Baggiani, G. ; Conti, U. ; Cabani, E. ; Del Citerna, F. ; Bartolozzi, A. ; Tonelli, L. ; Baldini, P. ; Tartarini, G. ; Orsini, E. ; Reishenofer, B. ; Giaconi, S. ; Levantesi, D. ; Dabizzi, R. ; Traini, A. M. ; Mondanelli, D. ; Magni, M. ; Pesola, A. ; Nevola, D. ; Poddighe, R. ; Galiotto, S. ; Saba, G. ; Rey, L. ; Provvidenza, M. ; Piccioni, N. / La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma. In: Italian Heart Journal Supplement. 2002 ; Vol. 3, No. 6. pp. 613-618.

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title = "La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma",

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.",

keywords = "Appropriateness, Echocardiography",

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

year = "2002",

language = "Italian",

volume = "3",

pages = "613--618",

journal = "Italian Heart Journal Supplement",

issn = "1129-4728",

publisher = "Centro Editoriale Pubblicitario Italiano",

number = "6",

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TY - JOUR

T1 - La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma

AU - Lattanzi, Fabio

AU - Magnani, Mirco

AU - Cortigiani, Lauro

AU - Mandorla, Sara

AU - Zuppiroli, Alfredo

AU - Lorenzoni, Roberto

AU - Macrì, R.

AU - Bernardi, D.

AU - Volterrani, C.

AU - Mazzoni, V.

AU - Barletta, G.

AU - Gensini, G. F.

AU - Mazzuoli, F.

AU - Mori, F.

AU - Pieri, F.

AU - Vergassola, R.

AU - Nannini, M.

AU - Zambaldi, G.

AU - Cerisano, S.

AU - Landini, C.

AU - Severi, S.

AU - Genovesi Ebert, A.

AU - Digiorgio, A.

AU - Venturini, C.

AU - Raugi, M.

AU - Baldini, U.

AU - Savoia, M. T.

AU - Paoletti, M.

AU - Odoguardi, L.

AU - Zanetti, L.

AU - Lazzari, M.

AU - Bonatti, V.

AU - Giannini, R.

AU - Vergoni, W.

AU - Franchi, A.

AU - De Tommasi, M.

AU - Boem, A.

AU - Fontanive, P.

AU - Ferrante, G.

AU - Baggiani, G.

AU - Conti, U.

AU - Cabani, E.

AU - Del Citerna, F.

AU - Bartolozzi, A.

AU - Tonelli, L.

AU - Baldini, P.

AU - Tartarini, G.

AU - Orsini, E.

AU - Reishenofer, B.

AU - Giaconi, S.

AU - Levantesi, D.

AU - Dabizzi, R.

AU - Traini, A. M.

AU - Mondanelli, D.

AU - Magni, M.

AU - Pesola, A.

AU - Nevola, D.

AU - Poddighe, R.

AU - Galiotto, S.

AU - Saba, G.

AU - Rey, L.

AU - Provvidenza, M.

AU - Piccioni, N.

PY - 2002

Y1 - 2002

N2 - 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.

AB - 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.

KW - Appropriateness

KW - Echocardiography

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M3 - Articolo

C2 - 12116810

AN - SCOPUS:20244383269

VL - 3

SP - 613

EP - 618

JO - Italian Heart Journal Supplement

JF - Italian Heart Journal Supplement

SN - 1129-4728

IS - 6

ER -

La valutazione dell'appropriatezza della prescrizione dell'ecocardiogramma

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