Use of non-indicated cardiac testing in low-risk patients: Choosing Wisely

doi:10.1136/bmjqs-2014-003087

. 2015 Feb;24(2):149-53.

doi: 10.1136/bmjqs-2014-003087. Epub 2014 Aug 5.

Use of non-indicated cardiac testing in low-risk patients: Choosing Wisely

Carrie H Colla¹, Thomas D Sequist², Meredith B Rosenthal³, William L Schpero⁴, Daniel J Gottlieb⁴, Nancy E Morden⁵

Affiliations

¹ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
² Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Partners HealthCare, Boston, Massachusetts, USA.
³ Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA.
⁴ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.
⁵ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.

PMID: 25096264
PMCID: PMC4303489
DOI: 10.1136/bmjqs-2014-003087

Use of non-indicated cardiac testing in low-risk patients: Choosing Wisely

Carrie H Colla et al. BMJ Qual Saf. 2015 Feb.

. 2015 Feb;24(2):149-53.

doi: 10.1136/bmjqs-2014-003087. Epub 2014 Aug 5.

Authors

Carrie H Colla¹, Thomas D Sequist², Meredith B Rosenthal³, William L Schpero⁴, Daniel J Gottlieb⁴, Nancy E Morden⁵

Affiliations

¹ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA.
² Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA Division of General Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA Partners HealthCare, Boston, Massachusetts, USA.
³ Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA.
⁴ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.
⁵ The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.

PMID: 25096264
PMCID: PMC4303489
DOI: 10.1136/bmjqs-2014-003087

No abstract available

Keywords: Evidence-Based Medicine; Health Services Research; Performance Measures.

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Figures

**Figure 1**
Map of the potentially non-indicated cardiac testing prevalence for the low-risk cohort across 306 hospital referral regions, 2011. Testing prevalence indicates per cent of beneficiaries with one or more tests in the calendar year. Cardiac testing was higher in the southern and eastern regions of the USA. Data reflect 1.6 million person-years in the low-risk cohort.

See this image and copyright information in PMC

Comment in

Low value cardiac testing and Choosing Wisely.
Bhatia RS, Levinson W, Lee DS. Bhatia RS, et al. BMJ Qual Saf. 2015 Feb;24(2):89-91. doi: 10.1136/bmjqs-2014-003605. Epub 2014 Oct 10. BMJ Qual Saf. 2015. PMID: 25304842 No abstract available.

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References

1. Choosing Wisely. ABIM Foundation; 2013.
1. Kale MS, Bishop TF, Federman AD, et al. Trends in the overuse of ambulatory health care services in the United States. JAMA Intern Med. 2013;173:142–8. - PMC - PubMed
1. Schwartz AL, Landon BE, Elshaug AG, et al. Measuring low-value care in medicare. JAMA Intern Med. 2014;174:1067–76. - PMC - PubMed
1. Lucas FL, DeLorenzo MA, Siewers AE, et al. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993–2001. Circulation. 2006;113:374–9. - PMC - PubMed
1. Chan B, Cox JL, Anderson G. Trends in the utilization of noninvasive cardiac diagnostic tests in Ontario from fiscal year 1989/90 to 1992/93. Can J Cardiol. 1996;12:237–48. - PubMed

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[1] Choosing Wisely. ABIM Foundation; 2013.

[2] Choosing Wisely. ABIM Foundation; 2013.

[3] Kale MS, Bishop TF, Federman AD, et al. Trends in the overuse of ambulatory health care services in the United States. JAMA Intern Med. 2013;173:142–8. - PMC - PubMed

[4] Kale MS, Bishop TF, Federman AD, et al. Trends in the overuse of ambulatory health care services in the United States. JAMA Intern Med. 2013;173:142–8. - PMC - PubMed

[5] Schwartz AL, Landon BE, Elshaug AG, et al. Measuring low-value care in medicare. JAMA Intern Med. 2014;174:1067–76. - PMC - PubMed

[6] Schwartz AL, Landon BE, Elshaug AG, et al. Measuring low-value care in medicare. JAMA Intern Med. 2014;174:1067–76. - PMC - PubMed

[7] Lucas FL, DeLorenzo MA, Siewers AE, et al. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993–2001. Circulation. 2006;113:374–9. - PMC - PubMed

[8] Lucas FL, DeLorenzo MA, Siewers AE, et al. Temporal trends in the utilization of diagnostic testing and treatments for cardiovascular disease in the United States, 1993–2001. Circulation. 2006;113:374–9. - PMC - PubMed

[9] Chan B, Cox JL, Anderson G. Trends in the utilization of noninvasive cardiac diagnostic tests in Ontario from fiscal year 1989/90 to 1992/93. Can J Cardiol. 1996;12:237–48. - PubMed

[10] Chan B, Cox JL, Anderson G. Trends in the utilization of noninvasive cardiac diagnostic tests in Ontario from fiscal year 1989/90 to 1992/93. Can J Cardiol. 1996;12:237–48. - PubMed

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Use of non-indicated cardiac testing in low-risk patients: Choosing Wisely

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Use of non-indicated cardiac testing in low-risk patients: Choosing Wisely

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