title: Stress-echocardiography is underused in clinical practice: a nationwide survey in Austria.
abstract: BACKGROUND
  The wide area of application, including coronary artery disease, valvular heart disease, or pulmonary hypertension makes stress echocardiography (SE) a powerful, cost-effective imaging modality in cardiology. The role of this technique in clinical practice in Austria is unknown.
  
  
  METHODS
  A nationwide survey included all departments for cardiology and/or internal medicine in the years 2008 and 2013. By electronic questionnaire demographics, indication for the test, the numbers of examined cases per year, operators, and various applied techniques of SE were interrogated and completed by telephone interviews.
  
  
  RESULTS
  Data could be obtained from all 117 departments. In the year 2007 in 58 (50%) and in 2012 57 (49%) departments SE was available in Austrian hospitals. More than 100 SEs per year were performed by only four (7%) units in the year 2007 and by five (8%) in 2012. Physical exercise, dobutamine, and dipyridamole SE were available in 27 (46%), 52 (90%), and six (10%) units in 2007, and in 15 (27%), 52 (91%), and five (9%) units in 2012, respectively. In 2007 41 (71%) and in 2012 26 (46%) echo-labs administered contrast agents during SE. Transesophageal SE and 3D-echo was performed in one (2%) and three (5%) units in 2007, and in six (10%) and four (7%) echo-labs in 2012.
  
  
  CONCLUSIONS
  This representative survey demonstrates the underuse of SE in clinical practice in Austria. Even in established application fields performance is low, examination frequencies as recommended by the cardiology societies are fulfilled only by a minority of institutions.
authors.affiliation: Division of Cardiology, Department of Internal Medicine II, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
authors.forename: David
authors.initials: D
authors.lastname: Weidenauer
authors.forename: Philipp
authors.initials: P
authors.lastname: Bartko
authors.forename: Heidemarie
authors.initials: H
authors.lastname: Zach
authors.forename: Manfred
authors.initials: M
authors.lastname: Zehetgruber
authors.forename: Hans
authors.initials: H
authors.lastname: Domanovits
authors.forename: Senta
authors.initials: S
authors.lastname: Graf
authors.forename: Gerald
authors.initials: G
authors.lastname: Mundigler
mesh_terms: D001317:Austria / Q000453:epidemiology; D025401:Echocardiography, Stress / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006331:Heart Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D014600:Utilization Review