Use of a Web-Based Application of the American College of Cardiology Foundation/American Society of Echocardiography Appropriateness Use Criteria for Transthoracic Echocardiography: A Pilot Study
| Autor: | Ibrahim N. Mansour, Nicole M. Bhave, R. Parker Ward, Roberto M. Lang, Federico Veronesi, Rabia R. Razi |
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| Rok vydání: | 2011 |
| Předmět: |
Internet
medicine.medical_specialty business.industry Data Collection Medical record Echo (computing) Imaging Procedures Entry time University hospital United States Appropriate Use Criteria Cohen's kappa Echocardiography Internal medicine Practice Guidelines as Topic medicine Cardiology Humans Web application Radiology Nuclear Medicine and imaging Guideline Adherence Practice Patterns Physicians' Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of the American Society of Echocardiography. 24:271-276 |
| ISSN: | 0894-7317 |
| DOI: | 10.1016/j.echo.2010.12.027 |
| Popis: | Background Clinical application of the American College of Cardiology Foundation Appropriate Use Criteria (AUC) represents a potentially feasible alternative to third-party pre-certification for imaging procedures and will soon be required as part of the accreditation process for imaging laboratories. Electronic tools that rapidly apply the AUC are needed in clinical practice. We developed and tested a web-based application of the AUC to track appropriateness of transthoracic echocardiography (TTE). Methods Indications for outpatient TTE studies performed in a university hospital echocardiography laboratory were assessed prospectively at the point of service using a prototype web-based AUC application (Echo AUC App). The Echo AUC App was developed on the basis of our own prior published data regarding indication frequency to minimize time and screens required for completion. Echo AUC App-determined indications were compared with blinded investigator-determined indications based on review of relevant medical records. Echo AUC App characteristics, including Echo AUC App entry time, were recorded. Results Of the 258 studies enrolled, Echo AUC App-determined TTE indications were Appropriate (A) in 77% ( n = 198), Inappropriate (I) in 9% ( n = 23), and Not Classified (NC) by the AUC in 14% ( n = 37). Agreement between Echo AUC App- and investigator-determined classifications was excellent (94%, kappa statistic 0.83). Mean Echo AUC App study entry time was 55 seconds (range 25-280 seconds). Conclusion The use of an electronic application allows rapid and accurate implementation of the AUC for TTE at the point of service. Such an application could be installed in echocardiography laboratories to track appropriateness in accordance with soon-to-be-implemented accreditation requirements. Further study of this Echo AUC App at the point of order may provide an alternative to third-party pre-certification procedures. |
| Databáze: | OpenAIRE |
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