Impact of the 2016 ASE/EACVI Guidelines on diastolic function reporting in routine clinical practice.

Autor: Gopalakrishnan P; Division of Cardiology, Aultman Hospital, Canton, Ohio., Biederman R; Gerald McGinnis Cardiovascular Institute, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Jazyk: angličtina
Zdroj: Echocardiography (Mount Kisco, N.Y.) [Echocardiography] 2020 Apr; Vol. 37 (4), pp. 546-553. Date of Electronic Publication: 2020 Apr 16.
DOI: 10.1111/echo.14645
Abstrakt: Objective: To evaluate the impact of 2016 ASE/EACVI guidelines on Diastolic Function (DF) reporting during routine clinical practice.
Methods: Transthoracic echos performed 9 months before and 18 months after the 2016 guidelines (DF2016) were retrospectively analyzed.
Results: Twenty thousand eight hundred forty three echos performed between July 1, 2015, and September 30, 2017, were analyzed. Quarterly trends showed a stable proportion of normal DF (nDF), diastolic dysfunction (DD), indeterminate DF (DF-I), and nonreported DF (DF-NR) for 3 quarters preceding DF2016. After DF2016 release, reporting of DD decreased by 57% (P < .001), nDF increased by 76% (P < .001), DF-NR increased by 266% (P < .001), and DF-I did not change significantly (P = .40). Grade 1 DD decreased by 64% (P < .001), grade 2 DD decreased by 51% (P < .001), and grade 3 DD did not change significantly (P = .18). Provider level analysis showed increased heterogeneity in grade 1 DD reporting and decreased heterogeneity in DD grades 2 or higher, after DF2016. Systolic dysfunction reporting remained relatively stable (22%→21%→20%) compared to a significant decrease in isolated DD (35%→21%→10%).
Conclusion: The 2016 guidelines update has impacted DF reporting patterns significantly. The likelihood of reporting DD decreased significantly, especially for grades 1 and 2. Inter-provider heterogeneity in DF reporting improved for grades 2 and 3 but worsened for grade 1. There was more than threefold increase in failure to report DF, suggesting a decrease in provider confidence.
(© 2020 Wiley Periodicals, Inc.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje