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(Journal Article) |
《Netherlands Heart Journal Monthly Journal of t... 25: 330- (2017)
Appropriate use criteria for echocardiography in the Netherlands
BJ Bouma
,
R Riezenbos
,
AJ Voogel
,
MH Veldhorst
,
W Jaarsma
ABSTRACT
Appropriate use criteria (AUC) for echocardiography based on clinical scenarios were previously published by an American Task Force. We determined whether members of the Dutch Working Group on Echocardiography (WGE) would rate these scenarios in a02similar way. All 3202members of the WGE were invited to judge clinical scenarios independently using a02blanked version of the previously published American version of AUC for echocardiography. During a02face-to-face meeting, consensus about the final rating was reached by open discussion for each indication. For reasons of simplicity, the scores were reduced from a029-point scale to a023-point scale (indicating an appropriate, uncertain or inappropriate echo indication, respectively). Nine cardiologist members of the WGE reported their judgment on the echo cases (n= 153). Seventy-one indications were rated as appropriate, 35 were rated as uncertain, and 47 were rated as inappropriate. In 5% of the cases the rating was opposite to that in the original (appropriate compared with inappropriate and vice versa), whereas in 20% judgements differed by 1 level of appropriateness. After the consensus meeting, the appropriateness of 7 (5%) cases was judged differently compared with the original paper. Echocardiography was rated appropriate when it is applied for an initial diagnosis, a02change in clinical status or a02change in patient management. However, in about 5% of the listed clinical scenarios, members of the Dutch WGE rated the AUC for echocardiography differently as compared with their American counterparts. Further research is warranted to analyse this decreased external validity. The online version of this article (doi: 10.1007/s12471-017-0960-9) contains supplementary material, which is available to authorized users.