Outcomes issues regarding utilization of echocardiography in patients with known or suspected coronary artery disease.
In this opinion paper, outcomes issues that should determine the utilization of echocardiography in patients with known or suspected coronary artery disease is discussed. The issues discussed are the level of training and competence in performing and interpreting echocardiographic studies, sensitivity and specificity of the test in various conditions, ability to deal with artifacts, the pretest probability of disease, incremental value of a test in context of what is already known about a patient, cost-benefit analysis, and whether risk stratification is justified when risk management is not possible. Concepts, rather than an exhaustive view of the literature, are discussed and areas that require further investigation are mentioned.
Kaul
S
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Cardiovascular Division, University of Virginia School of Medicine, Charlottesville 22908, USA.
D016477:Artifacts; D002983:Clinical Competence; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000191:economics; D003362:Cost-Benefit Analysis; D004452:Echocardiography / Q000191:economics; D006801:Humans; D011336:Probability; D012308:Risk Management; D012680:Sensitivity and Specificity