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. 2017 May;25(5):330-334.
doi: 10.1007/s12471-017-0960-9.

Appropriate use criteria for echocardiography in the Netherlands

B J Bouma  1 , R Riezenbos  2 , A J Voogel  3 , M H Veldhorst  4 , W Jaarsma  5 , J Hrudova  6 , B Cernohorsky  6 , S Chamuleau  7 , R B A van den Brink  8 , R Breedveld  9 , C Reichert  10 , O Kamp  11 , R Braam  12 , J P van Melle  13
Affiliations

Appropriate use criteria for echocardiography in the Netherlands

B J Bouma et al. Neth Heart J. 2017 May.

Abstract

Introduction: 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 a similar way.

Methods: All 32 members of the WGE were invited to judge clinical scenarios independently using a blanked version of the previously published American version of AUC for echocardiography. During a face-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 a 9-point scale to a 3-point scale (indicating an appropriate, uncertain or inappropriate echo indication, respectively).

Results: 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.

Conclusions: Echocardiography was rated appropriate when it is applied for an initial diagnosis, a change in clinical status or a change 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.

Keywords: Appropriate use criteria; Cardiac imaging; Diagnostic testing; Echocardiography.

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Conflict of interest statement

B.J. Bouma, R. Riezenbos, A.J. Voogel, M.H. Veldhorst, W. Jaarsma, J. Hrudova, B. Cernohorsky, S. Chamuleau, R.B.A. van den Brink, R. Breedveld, C. Reichert, O. Kamp, R. Braam and J.P. van Melle declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Frequency distribution of agreement and disagreement with the original AUC of the nine individual WGE members in comparison with the original rating. The Y‑axis shows the number of clinical scenarios assessed
See this image and copyright information in PMC

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