Analysis: Introducing Left Ventricular TTEs Lowers Full Echocardiograms

A focused left ventricular transthoracic echocardiogram (TTE) option offered as a substitute for full echocardiography was associated with a decrease in the number of full echocardiograms, according to a new research letter published in JAMA Internal Medicine. Researchers evaluating the use of a left ventricle transthoracic option added by the Veterans Affairs Palo Alto Health Care System  (PAVA) compared the TTE volume and TTEs per 200 outpatient visits between the PAVA group and control groups.

Linear regression analysis showed an increase in the use of limited TTEs (P<0.001), but not total TTEs. Limited TTEs as a percentage of total TTEs also increased (from 0.8% in 2005 to 19.5% between 2011 and 2015). Multivariate regression analysis suggested that the introduction of limited left ventricular TTEs was associated with more limited TTEs (P<0.001), but not an overall increase in TTEs.  

“A focus of high-value care has been eliminating unnecessary testing. Another approach would be to identify lower-cost alternatives,” the authors wrote in their discussion. “Our study suggests that echocardiography testing can be redesigned to answer focused questions important to clinicians while reducing health care spending.” 

Source: JAMA Internal Medicine 

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