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Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography.

Publication ,  Journal Article
Sachdeva, R; Kelleman, MS; McCracken, CE; Campbell, RM; Lai, WW; Lopez, L; Stern, KWD; Welch, E; Douglas, PS
Published in: J Am Soc Echocardiogr
September 2017

BACKGROUND: A survey of pediatric cardiologists who participated in the Pediatric Appropriate Use of Echocardiography study was conducted to assess attitudes toward appropriate use criteria (AUC) and the relationship between perceptions of usefulness of a multifaceted educational intervention (EI) and the appropriateness of transthoracic echocardiography (TTE). METHODS: Self-reported helpfulness and impact of a four-component EI (feedback of personal appropriateness data before EI, lecture, self-assignment of AUC indications, and monthly feedback) was surveyed. Physicians' perceptions were correlated with measured changes in appropriateness after EI by center. RESULTS: Responses were obtained from 54 of 89 physicians (61%; 52% general cardiologists, 24% imaging specialists), and most (72%) felt that AUC were helpful in health care cost reduction. More physicians with ≤10 years of experience self-reported ordering TTE less often because of AUC (P = .04). Subspecialty did not influence TTE ordering practice. Centers whose physicians had higher rates of reading the document had higher appropriateness. A change in practice following EI was self-reported by 31 of 54 respondents (57%). All components of EI were felt to be helpful. Helpfulness and self-reported impact of each EI component tracked together (r = 0.61; 95% CI, 0.16-0.85; P = .01) but varied among centers. Centers with higher perceived practice impact of EI overall had greater changes in measured appropriateness after EI. CONCLUSIONS: AUC were perceived to be useful by a majority of pediatric cardiologists surveyed. Centers with a positive attitude toward AUC and higher engagement with EI had higher actual appropriateness of TTE orders. Improving physicians' attitudes toward AUC and EI may improve outpatient TTE utilization.

Duke Scholars

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

September 2017

Volume

30

Issue

9

Start / End Page

926 / 931.e2

Location

United States

Related Subject Headings

  • United States
  • Quality Improvement
  • Practice Patterns, Physicians'
  • Patient Selection
  • Humans
  • Guideline Adherence
  • Echocardiography
  • Child
  • Cardiovascular System & Hematology
  • Cardiologists
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sachdeva, R., Kelleman, M. S., McCracken, C. E., Campbell, R. M., Lai, W. W., Lopez, L., … Douglas, P. S. (2017). Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography. J Am Soc Echocardiogr, 30(9), 926-931.e2. https://doi.org/10.1016/j.echo.2017.05.007
Sachdeva, Ritu, Michael S. Kelleman, Courtney E. McCracken, Robert M. Campbell, Wyman W. Lai, Leo Lopez, Kenan W. D. Stern, Elizabeth Welch, and Pamela S. Douglas. “Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography.J Am Soc Echocardiogr 30, no. 9 (September 2017): 926-931.e2. https://doi.org/10.1016/j.echo.2017.05.007.
Sachdeva R, Kelleman MS, McCracken CE, Campbell RM, Lai WW, Lopez L, et al. Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography. J Am Soc Echocardiogr. 2017 Sep;30(9):926-931.e2.
Sachdeva, Ritu, et al. “Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography.J Am Soc Echocardiogr, vol. 30, no. 9, Sept. 2017, pp. 926-931.e2. Pubmed, doi:10.1016/j.echo.2017.05.007.
Sachdeva R, Kelleman MS, McCracken CE, Campbell RM, Lai WW, Lopez L, Stern KWD, Welch E, Douglas PS. Physician Attitudes toward the First Pediatric Appropriate Use Criteria and Engagement With Educational Intervention to Improve the Appropriateness of Outpatient Echocardiography. J Am Soc Echocardiogr. 2017 Sep;30(9):926-931.e2.
Journal cover image

Published In

J Am Soc Echocardiogr

DOI

EISSN

1097-6795

Publication Date

September 2017

Volume

30

Issue

9

Start / End Page

926 / 931.e2

Location

United States

Related Subject Headings

  • United States
  • Quality Improvement
  • Practice Patterns, Physicians'
  • Patient Selection
  • Humans
  • Guideline Adherence
  • Echocardiography
  • Child
  • Cardiovascular System & Hematology
  • Cardiologists