10 Choosing Wisely Recommendations for Hospitalists
Recommendation: Avoid echocardiograms for pre-operative/peri-operative assessment of patients with no history or symptoms of heart disease.
Echocardiography can diagnose all types of heart disease while being completely safe, inexpensive, and available at the bedside.
"These features may logically lead hospitalists to think, 'Why not?' Maybe there's something going on and an echo can't hurt," says James D. Thomas, MD, FASE, FACC, FAHA, FESC, Moore Chair of Cardiovascular Imaging at Cleveland Clinic and ASE past president. "Unfortunately, tests can have false positive findings that lead to other, potentially more hazardous and invasive, tests downstream, as well as unnecessary delays."
If a patient has no history of heart disease, no positive physical findings, or no symptoms, then an echo probably won't be helpful. Hospitalists need to be aware of the lack of value of a presumed normal study, Dr. Auron says.
"Having appropriate standards of care allows clinicians in pre-operative areas to use risk stratification tools in an adequate fashion," he notes.
5 American Society of Echocardiography (ASE)
Recommendation: Avoid echocardiograms for pre-operative/peri-operative assessment of patients with no history or symptoms of heart disease.
Echocardiography can diagnose all types of heart disease while being completely safe, inexpensive, and available at the bedside.
"These features may logically lead hospitalists to think, 'Why not?' Maybe there's something going on and an echo can't hurt," says James D. Thomas, MD, FASE, FACC, FAHA, FESC, Moore Chair of Cardiovascular Imaging at Cleveland Clinic and ASE past president. "Unfortunately, tests can have false positive findings that lead to other, potentially more hazardous and invasive, tests downstream, as well as unnecessary delays."
If a patient has no history of heart disease, no positive physical findings, or no symptoms, then an echo probably won't be helpful. Hospitalists need to be aware of the lack of value of a presumed normal study, Dr. Auron says.
"Having appropriate standards of care allows clinicians in pre-operative areas to use risk stratification tools in an adequate fashion," he notes.
SHARE
