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The American College of Cardiology has published the first appropriate use criteria for initial outpatient transthoracic echocardiography to evaluate children with possible heart disease.
The AUC-the product of a collaboration among 9 professional societies, including the American Academy of Pediatrics-are designed to help pediatric cardiologists, pediatricians, and family practitioners determine whether echocardiography or some other diagnostic approach would be more helpful in initially evaluating suspected heart disease in children. They address only first-time outpatient echocardiography, not posttest follow-up, inpatient echocardiography, or evaluation of known cardiac abnormalities.
The criteria classify 113 indications for first-time echocardiography into 1 of 9 common types of clinical presentation, including arrhythmias and palpitations, syncope, chest pain, and murmur. Researchers evaluated each indication and rated its appropriateness on a scale of 1 to 9; 53 indications were deemed “appropriate,” 28 “may be appropriate,” and 32 “rarely appropriate.”
In addition to helping clinicians make better use of outpatient echocardiography, the criteria lay the foundation for developing further use criteria in pediatric cardiology and designing projects to improve patient care, the AUC report concludes. The criteria will be posted on the websites of the American College of Cardiology, the American Society of Echocardiography, and the Society for Cardiovascular Angiography and Interventions.
Several members of the ratings panel and task force working on the criteria reported financial relationships with medical device manufacturers.
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