Utilization of echocardiography by internists and cardiologists: a comparative study.
OBJECTIVE
To compare the utilization of echocardiography as a diagnostic tool by internists and cardiologists.


METHODS
Retrospective study.


METHODS
Tertiary care university hospital.


METHODS
Indications and clinical utility of echocardiographic studies ordered by cardiologists (group A, n = 301) and internists (group B, n = 297) were compared by chart review. The two groups of patients were analyzed to determine if the studies detected new cardiac pathology and/or altered patient management.


RESULTS
The proportion of studies with abnormal results were similar in both groups (19% versus 14%, P > 0.05). The results of echocardiography, however, led to a change in management more often when the study was ordered by cardiologists (16% versus 10%, P < 0.05). A significantly greater proportion of studies were ordered for evaluation of valvular function by internists (44% versus 33%, P < 0.05). Echocardiography detected valvular abnormalities in a similar proportion of cases in groups A and B (14% versus 10%, P > 0.05). However, diagnostic yield was very poor when the study was performed in patients with suspected mitral valve prolapse in both groups. Cardiologists utilized echocardiography more often for evaluation of left ventricular function (35% versus 18%, P < 0.01) and in the setting of atherosclerotic heart disease for detecting wall motion abnormalities (14% versus 5%, P < 0.01).


CONCLUSIONS
Diagnostic yield of echocardiography is similar when ordered by internists and cardiologists. With the information obtained, management is altered in a slightly greater proportion of cases involving a cardiologist. This may be due to utilization of echocardiography more often for estimating left ventricular function and for detecting wall motion abnormalities by cardiologists.
Calenda
P
P
Department of Medicine, State University of New York, Health Science Center, Stony Brook, USA.
Jain
P
P
Smith
L G
LG
D000328:Adult; D002309:Cardiology / Q000706:statistics & numerical data*; D003937:Diagnosis, Differential; D004452:Echocardiography / Q000706:statistics & numerical data*; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D006785:Hospitals, University; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data*; D008499:Medical Records; D008875:Middle Aged; D009200:Myocardial Contraction; D012189:Retrospective Studies; D016277:Ventricular Function, Left