title: [Appropriateness of diagnostic tests in cardiovascular prevention: what can we skip?].
abstract: In recent years, a huge increase in the use of cardiac procedures, both invasive and non-invasive, was observed. Diagnostic tests, mainly non-invasive tests, are often prescribed inappropriately, in most cases replacing the clinical evaluation. The rate of inappropriate tests in cardiology is largely variable, depending on regional issues and different medical approach. When the test entails radiation exposure, the biological risk for both the patient and the environment must be taken into account. For this reason, the test that results in less biological risk should always be preferred as a first step.Moreover, it has not been clearly demonstrated that some diagnostic tests help to improve the outcome, that is to prevent cardiovascular events. As many as one sixth of the patients who undergo stress imaging are not taking proper medication, and very frequently no change in therapy is made after the test, regardless of the outcome. Since the appropriateness of diagnostic evaluation requests is mandatory, we focused on the diagnostic tests usually performed in primary and secondary prevention that carry no contribution to the clinical management of patients. This review addresses the need to optimize available resources, reduce costs and avoid unnecessary cardiovascular assessments, thereby enhancing the more efficient care delivery models.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cherubini
authors.forename: Gian Francesco
authors.initials: GF
authors.lastname: Mureddu
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Temporelli
authors.forename: Anna
authors.initials: A
authors.lastname: Frisinghelli
authors.forename: Piero
authors.initials: P
authors.lastname: Clavario
authors.forename: Francesca
authors.initials: F
authors.lastname: Cesana
authors.forename: Francesco
authors.initials: F
authors.lastname: Fattirolli
mesh_terms: D001774:Blood Chemical Analysis / Q000191:economics / Q000706:statistics & numerical data; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics / Q000235:genetics / Q000517:prevention & control*; D017046:Cost Savings; D003952:Diagnostic Imaging / Q000191:economics / Q000706:statistics & numerical data; D003935:Diagnostic Techniques, Cardiovascular / Q000009:adverse effects / Q000191:economics / Q000706:statistics & numerical data*; D060005:Genotyping Techniques / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007558:Italy; D011300:Preoperative Care / Q000706:statistics & numerical data; D011322:Primary Prevention; D011859:Radiography / Q000009:adverse effects / Q000706:statistics & numerical data; D055502:Secondary Prevention; D019564:Unnecessary Procedures / Q000191:economics