Study Shows Educational Intervention Improves Appropriate Use of TTE

According to a study published on April 10 in JACC Cardiovascular Imaging, educational efforts produced a significant reduction in the amount of inappropriate transthoracic echocardiography (TTE) ordering and increased the amount of appropriate TTE ordering in an inpatient academic medical setting.

The study looked at ordering of medical services between a control period and educational intervention, which included a lecture on the College's Appropriate Use Criteria (AUC) for TTE, a pocket card with common clinical scenarios, and biweekly e-mails with ordering behavior feedback.

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Results showed that there was a 26 percent reduction in the number of TTE ordered per day compared with the number ordered during the control period (2.9 vs. 3.9 TTE, p < 0.001). Further, the proportion of inappropriate TTE was significantly lower (5 percent vs. 13 percent p < 0.001), and the proportion of appropriate TEE was significantly higher (93 percent vs. 84 percent, p < 0.001).

"The growth of cardiac imaging, including echocardiography, has led to efforts by the ACC and other subspecialty organizations to create AUC," the authors note. They add that this is the first study to show that an AUC-based educational intervention can reduce the rate of inappropriate TTE.

Based on their results, the authors conclude that "this study provides a practical approach of adapting the AUC to local practice patterns in an effort to improve use of medical resources and to reduce the number of unnecessary cardiac imaging tests."

Keywords: Health Resources, Inpatients, Feedback, Echocardiography

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