We have located links that may give you full text access.
Stress Electrocardiography vs Radionuclide Myocardial Perfusion Imaging among Patients Admitted for Chest Pain: Comparison of Teaching and Nonteaching Hospital Services.
Southern Medical Journal 2018 December
OBJECTIVES: The American Board of Internal Medicine Foundation's Choosing Wisely initiative has identified the routine use of stress cardiac imaging among lower-risk patients as an expensive test that should be questioned by both physicians and patients. The objectives of this study were to determine how often patients hospitalized for chest pain are assessed with stress electrocardiography (stress ECG) compared with radionuclide myocardial perfusion imaging (rMPI) and to evaluate whether the cardiac testing guidelines of the American Heart Association and the Choosing Wisely campaign are being followed. We also sought to determine whether there were differences in practice patterns between a teaching and a nonteaching hospital service.
METHODS: We conducted a retrospective chart review of 842 consecutive patients admitted with the primary diagnosis of chest pain to a 900-bed university-affiliated teaching hospital in Dayton, Ohio. After exclusions, we analyzed records from 111 teaching service and 94 nonteaching service patients. We assessed whether patients were evaluated with stress ECG or rMPI and compared the teaching service with the nonteaching service.
RESULTS: The nonteaching service obtained rMPI more often than the teaching service (94% vs 51%, P < 0.001) and stress ECG less frequently than the teaching service (1% vs 12%, P < 0.003). Both groups may have overused rMPI, choosing it over the less costly alternative of stress ECG testing 71% of the time.
CONCLUSIONS: Adherence to the Choosing Wisely recommendations for the appropriate use of stress ECG is suboptimal among both teaching and nonteaching physicians. Choosing stress ECG, when appropriate, could translate into substantial cost savings and reduce potentially harmful radiation exposure.
METHODS: We conducted a retrospective chart review of 842 consecutive patients admitted with the primary diagnosis of chest pain to a 900-bed university-affiliated teaching hospital in Dayton, Ohio. After exclusions, we analyzed records from 111 teaching service and 94 nonteaching service patients. We assessed whether patients were evaluated with stress ECG or rMPI and compared the teaching service with the nonteaching service.
RESULTS: The nonteaching service obtained rMPI more often than the teaching service (94% vs 51%, P < 0.001) and stress ECG less frequently than the teaching service (1% vs 12%, P < 0.003). Both groups may have overused rMPI, choosing it over the less costly alternative of stress ECG testing 71% of the time.
CONCLUSIONS: Adherence to the Choosing Wisely recommendations for the appropriate use of stress ECG is suboptimal among both teaching and nonteaching physicians. Choosing stress ECG, when appropriate, could translate into substantial cost savings and reduce potentially harmful radiation exposure.
Full text links
Related Resources
Trending Papers
Autoimmune Hemolytic Anemias: Classifications, Pathophysiology, Diagnoses and Management.International Journal of Molecular Sciences 2024 April 13
Executive Summary: State-of-the-Art Review: Unintended Consequences: Risk of Opportunistic Infections Associated with Long-term Glucocorticoid Therapies in Adults.Clinical Infectious Diseases 2024 April 11
Clinical practice guidelines on the management of status epilepticus in adults: A systematic review.Epilepsia 2024 April 13
Finerenone: From the Mechanism of Action to Clinical Use in Kidney Disease.Pharmaceuticals 2024 March 27
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app