title: How I do it: judging appropriateness for TTE and TEE.
abstract: The increasing cost of healthcare is a widespread international problem to which the cost of imaging has been an important contributor. Some imaging tests are ordered inappropriately and contribute to wasted use of resources. Appropriate use criteria have been developed in the USA in order to guide test selection, but there are a number of problems, including the evidence base for these criteria and the steps that can be taken to change physician practice. A restrictive approach to test ordering is difficult to fit to the nuances of clinical presentation and may compromise patient care. We propose an alternative approach to physician guidance based on the most common markers of inappropriate testing.
authors: Ricardo
authors: R
authors: Fonseca
authors: Menzies Research Institute Tasmania, 17 Liverpool St, Hobart, Tasmania 7000, Australia. Tom.Marwick@utas.edu.au.
authors: Thomas H
authors: TH
authors: Marwick
mesh_terms: D057791:Cardiac Imaging Techniques / Q000191:economics / Q000379:methods / Q000706:statistics & numerical data; D002309:Cardiology / Q000191:economics*; D004452:Echocardiography / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D017548:Echocardiography, Transesophageal / Q000191:economics / Q000379:methods* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000191:economics / Q000379:methods; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006331:Heart Diseases / Q000000981:diagnostic imaging* / Q000191:economics; D006801:Humans; D010818:Practice Patterns, Physicians'; D014481:United States; D019564:Unnecessary Procedures