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Invited Commentary
September 23, 2013

Appropriate Use Criteria in Echocardiography: Is No Change the Same as No Benefit?

Author Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor
JAMA Intern Med. 2013;173(17):1609-1610. doi:10.1001/jamainternmed.2013.7273

Matulevicius and colleagues1 compare the clinical impact of transthoracic echocardiograms (TTEs) with the classification of the echocardiogram by the 2011 appropriate use criteria (AUC).2 They find that, although 91.8% of TTEs were appropriate, only 1 in 3 resulted in an active change in clinical management; approximately 1 in 2, in continuation of current care; and approximately 20%, in no change in current care. The degree to which these outcomes are exclusively shortcomings of the AUC is debatable but raises concerns that further modifications—and probably physician education—are necessary to achieve a more efficient use of echocardiography and conserve resources.

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