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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
10
|
| pubmed:dateCreated |
1997-12-9
|
| pubmed:abstractText |
The usefulness and cost of echocardiography was evaluated in 133 consecutive patients admitted to the Coronary Care Unit. A useful echocardiogram was one that provided new information, which influenced diagnosis, prognosis, or treatment. The cost of a useful echocardiogram was defined as the unit cost ($476 the Medicare global fee) x units (i.e., total echocardiograms / useful echocardiograms). Admission diagnoses were unstable angina (34%), arrhythmia (14%), congestive heart failure (8%), postprocedure monitoring (7%), acute myocardial infarction (6%), and miscellaneous (20%). The echocardiogram provided new information in 29% of patients. Patients without a recent echocardiogram (within 3 months) were twice as likely to have a useful echocardiogram (33 of 99, 33%) as those with a recent echocardiogram (5 of 34, 15%, p <0.05). A cardiologist predicted the overall usefulness of echocardiography with a positive predictive accuracy of 52% and a negative predictive accuracy of 94% (p < 0.0001). The overall cost of a useful echocardiogram of 3.5 units or $1,666 per useful study was decreased to $904 (1.9 units) if only studies predicted to be useful were considered. The usefulness of echocardiography varied significantly (p <0.02) within the admitting diagnostic categories. The usefulness of an echocardiogram was underestimated in patients with congestive heart failure, where it was found to be most useful (64%; $762 or 1.6 units). Thus, usefulness relates to the admission diagnosis, the availability of a recent echocardiogram, and to clinical judgment.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Nov
|
| pubmed:issn |
0002-9149
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:day |
15
|
| pubmed:volume |
80
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1273-6
|
| pubmed:dateRevised |
2004-11-17
|
| pubmed:meshHeading |
pubmed-meshheading:9388097-Aged,
pubmed-meshheading:9388097-Coronary Care Units,
pubmed-meshheading:9388097-Diagnosis, Differential,
pubmed-meshheading:9388097-Echocardiography,
pubmed-meshheading:9388097-Echocardiography, Doppler,
pubmed-meshheading:9388097-Female,
pubmed-meshheading:9388097-Heart Diseases,
pubmed-meshheading:9388097-Humans,
pubmed-meshheading:9388097-Hypertension, Pulmonary,
pubmed-meshheading:9388097-Male,
pubmed-meshheading:9388097-Middle Aged,
pubmed-meshheading:9388097-Predictive Value of Tests
|
| pubmed:year |
1997
|
| pubmed:articleTitle |
Clinical usefulness and cost of echocardiography in patients admitted to a coronary care unit.
|
| pubmed:affiliation |
Department of Medicine, University of Miami School of Medicine, Department of Veterans Affairs Medical Center, Florida 33125, USA.
|
| pubmed:publicationType |
Journal Article
|