Echocardiography Practice: Insights into Appropriate Clinical Use, Technical Competence and Quality Improvement Program

Abstract

Echocardiography accounts for nearly half of all cardiac imaging techniques. It is a widely available and adaptable tool, as well as being a cost-effective and mainly a non-invasive test. In addition, echocardiography provides extensive clinical data, which is related to the presence or advent of different modalities (tissue Doppler imaging, speckle tracking imaging, three-dimensional mode, contrast echo, etc.), different approaches (transesophageal, intravascular, etc.), and different applications (ie, heart failure/resynchronization studies, ischemia/stress echo, etc.). In view of this, it is essential to conform to criteria of appropriate use and to keep standards of competence. In this study, we sought to review and discuss clinical practice of echocardiography in light of the criteria of appropriate clinical use, also we present an insight into echocardiographic technical competence and quality improvement project.

Appropriate Use Criteria in Echocardiography: An Observational Institutional Study with the Perspective of a Quality Improvement Project

“…As the field of echocardiography continues to advance, the health-care community needs to understand how to best incorporate this technology into daily clinical care. 5 , 6 In the present study, we provide an estimate of whether TTE indications in a university hospital in Lebanon were appropriate according to the AUC 2011. The particularity of this study is its pilot nature in Lebanon, and the location is also of note because this study was conducted outside the USA, where AUC 2011 were established.…”

“…In this respect, a QIP is expected to be beneficial in terms of sensitizing practitioners, namely, cardiologists, to a tailored, individualized, and evidence-based approach in cardiovascular imaging, and particularly echocardiography. 5 …”

A standardized imaging protocol improves quality and reduces practice variability in echocardiographic assessment of ventricular function by first‐year pediatric cardiology fellows

“…The first portion of the protocol stipulated important information to be included in the report, including notation of the height, weight, and blood pressure as well as a proper indication for the study. 10 The indication was expected to include the original cardiac diagnosis, any prior surgeries or procedures, and the immediate clinical concern prompting the need for the study during off-hours (proper indication). The cardiology attending ordering the study also was required to be listed by name on the report (ie, not "CICU" or "Consult Service") to allow for ease in communication of important findings.…”

Tissue doppler imaging in cardiology nowadays: clinical applications

“…As for the E' acquisition, Sm acquisition is relatively feasible even when sonographic signal is relatively poor, however a good alignment is necessary given the angle-dependency. For the RV, TDI is used usually in conjunction with TAPSE (tricuspid annulus plane systolic excursion) at the level of basal RV free wall; contrary to the Sm value, TDI of the lateral RV free wall is indicative of the global RV function and not only local wall motion [4]. TDI assessment of LV systolic function is particularly important in subclinical LV systolic dysfunction given that Sm showed to be a sensitive marker of early LV systolic dysfunction.…”