Ultrasound detection of increased carotid intima-media thickness and carotid plaque in an office practice setting: does it affect physician behavior or patient motivation?
BACKGROUND
The aim of this multicenter study was to determine if identifying increased carotid intima-media thickness (CIMT) or carotid plaque during office-based ultrasound screening examinations could alter physicians' treatment plans and patients' motivation regarding health-related behaviors.


METHODS
Carotid ultrasound studies were performed by a nonsonographer clinician using a handheld system. Changes in physicians' treatment plans and patients' motivation on the basis of scan results were analyzed using multivariate regression.


RESULTS
There were 253 subjects (mean age, 58.1 +/- 6.6 years). When increased CIMT or carotid plaque was detected, physicians were more likely to prescribe aspirin and lipid-lowering therapy (P < .001). Subjects were more likely to report increases in plans to take cholesterol-lowering medication (P = .002) and the perceived likelihood of having or developing heart disease (P = .004).


CONCLUSIONS
Findings from office-based carotid ultrasound studies can influence physicians' prescriptions of evidence-based interventions. Patients with abnormal ultrasound findings recognize their increased cardiovascular risk and plan to take cholesterol-lowering medication.
Korcarz
Claudia E
CE
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
DeCara
Jeanne M
JM
Hirsch
Alan T
AT
Mohler
Emile R
ER
Pogue
Bryan
B
Postley
John
J
Tzou
Wendy S
WS
Stein
James H
JH
D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009819:Office Visits / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000706:statistics & numerical data*; D014922:Wisconsin / Q000453:epidemiology