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.
Armstrong W, Eagle KA. Appropriate Use Criteria in EchocardiographyIs No Change the Same as No Benefit?. JAMA Intern Med. 2013;173(17):1609–1610. doi:10.1001/jamainternmed.2013.7273