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Assessment of adequacy of echocardiographic examinations and indications of its prognostic value in cardiac diagnostic tertiary level center

Grant number: 13/06099-9
Support Opportunities:Regular Research Grants
Start date: October 01, 2013
End date: September 30, 2015
Field of knowledge:Health Sciences - Medicine - Medical Clinics
Principal Investigator:Minna Moreira Dias Romano
Grantee:Minna Moreira Dias Romano
Host Institution: Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da USP (HCMRP). Secretaria da Saúde (São Paulo - Estado). Ribeirão Preto , SP, Brazil
Associated researchers:André Schmidt ; Benedito Carlos Maciel

Abstract

The use of Doppler echocardiography (DEC) in imaging cardiologic diagnosis is constantly increasing last decades, and it is not proportional to disease increment.Looking at this point, the American society of echocardiography, together with other scientific cardiology societies, have developed, in the last 5 years, consensus documents about the appropriateness of echocardiographic exams indications. This have created the Appropriateness Criteria (AC), last edition published in 2011. Since then, some north American studies evaluated medical services, both, in public or private scenarios and could detect the quality of medical actuation in soliciting DEC exams. Also this studies could test the efficiency of this criteria (AC) to make this evaluation. However, there are few studies evaluating the power of DEC results in predict clinical significant changes, according to its AC score. In Brazil, the public health model named "Sistema Único de Saúde" (SUS) have a progressive increase in DEC solicitations well above the capability to offer this exams. This is an important fact to generate a large amount of patients waiting for a schedule for the exam, and sometimes, this exam is achieved in a moment too distant of the clinical need. This is especially worrying when related to more complex examinations like stress or transesophageal echocardiography. Scientific data about the quality of DEC solicitations in SUS are very poor or absent, so as the prognostic implications of DEC results. Based on the above, this project have the objectives to evaluate if the DEC solicitations, in a tertiary health hospital with SUS actuation, are done according to the AC; and also to evaluate the impact of DEC results in predict prognostic informations based on its AC score. (AU)

Articles published in Agência FAPESP Newsletter about the research grant:
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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
DIAS ROMANO, MINNA MOREIRA; BRANCO, MARINA; MOREIRA, HENRIQUE TURIN; SCHMIDT, ANDRE; KISSLO, JOSEPH; MACIEL, BENEDITO CARLOS. Appropriate use of echocardiography and relation to clinical decision making in both inpatients and outpatients in a developing country. ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, v. 35, n. 1, p. 9-16, . (13/06099-9)