Open access echocardiography in management of heart failure in the community
- PMID: 7503841
- PMCID: PMC2549011
- DOI: 10.1136/bmj.310.6980.634
Open access echocardiography in management of heart failure in the community
Abstract
Objective: To assess the value of an open access echocardiography service.
Design: Study of new open access service for general practitioners, who were invited to refer patients taking diuretics for suspected heart failure, untreated patients with symptoms of possible heart failure, and asymptomatic patients with risk factors for left ventricular systolic dysfunction.
Setting: Regional cardiology centre.
Subjects: 259 consecutive patients.
Main outcome measures: Presence or absence of left ventricular systolic dysfunction and consequent changes in clinical management.
Results: 119 treated patients, 99 untreated patients, and nine asymptomatic patients were referred over five months. 32 were considered to be inappropriately referred. Among the treated patients, 31 had impaired left ventricular systolic function and five had valvular disease; angiotensin converting enzyme inhibitors were recommended for 34 of these patients. In addition, 53 were thought not to need diuretics. Eight untreated patients had impaired systolic function and six valvular disease.
Conclusions: The service was well used by general practitioners and led to advice to change management in more than two thirds of patients.
Comment in
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Open access echocardiography. Study's conclusion is misleading and cannot be generalised.BMJ. 1995 Jul 29;311(7000):326-7; author reply 327-8. doi: 10.1136/bmj.311.7000.326c. BMJ. 1995. PMID: 7503889 Free PMC article. No abstract available.
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Open access echocardiography. General practitioners use echocardiography approximately.BMJ. 1995 Jul 29;311(7000):325. doi: 10.1136/bmj.311.7000.325b. BMJ. 1995. PMID: 7633250 Free PMC article. No abstract available.
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Open access echocardiography. Hospital patients need open access echocardiography.BMJ. 1995 Jul 29;311(7000):326. doi: 10.1136/bmj.311.7000.326a. BMJ. 1995. PMID: 7633252 Free PMC article. No abstract available.
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Open access echocardiography. Service is valuable for evaluating murmurs too.BMJ. 1995 Jul 29;311(7000):326. doi: 10.1136/bmj.311.7000.326. BMJ. 1995. PMID: 7633253 Free PMC article. No abstract available.
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Open access echocardiography. Open access to specialist opinion is preferable.BMJ. 1995 Jul 29;311(7000):326; author reply 327-8. doi: 10.1136/bmj.311.7000.326b. BMJ. 1995. PMID: 7633254 Free PMC article. No abstract available.
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Open access echocardiography. Service should be reserved for equivocal cases.BMJ. 1995 Jul 29;311(7000):327; author reply 327-8. doi: 10.1136/bmj.311.7000.327. BMJ. 1995. PMID: 7633255 Free PMC article. No abstract available.
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Open access echocardiography. Single assessment may be dangerous.BMJ. 1995 Jul 29;311(7000):327; author reply 327-8. doi: 10.1136/bmj.311.7000.327a. BMJ. 1995. PMID: 7633256 Free PMC article. No abstract available.
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Open access echocardiography. Study's design leaves cost effectiveness and "therapeutic impact" in doubt.BMJ. 1995 Jul 29;311(7000):327; author reply 327-8. doi: 10.1136/bmj.311.7000.327b. BMJ. 1995. PMID: 7633257 Free PMC article. No abstract available.
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Open access echocardiography.BMJ. 1995 Aug 12;311(7002):453. doi: 10.1136/bmj.311.7002.453b. BMJ. 1995. PMID: 7640609 Free PMC article. No abstract available.
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Open access.BMJ. 1995 Mar 11;310(6980):611-2. doi: 10.1136/bmj.310.6980.611. BMJ. 1995. PMID: 7703735 Free PMC article. No abstract available.
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